PAID CLAIMS DETAIL                                                  
                                     Product/Sub Group-8 Digit/Payroll Location                                      

INVOICE NUMBER:     230110581479                                           PAGE:               1 of 67           
BILL ACCOUNT NUMBER:2401631001                                             PAID CLAIMS MONTH:  January 2023      
BILL ACCOUNT NAME:  Utz Quality Foods                                      CLAIMS PAID THRU:   01/06/2023        
CLIENT NUMBER:      240163                                                 BILL CYCLE:         1 of 4            
CLIENT NAME:        Utz Quality Foods                                      PREPARED DATE:      01/10/2023        

            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
HDHP PPO
  025620-00
    ACCTS
      ACCTS                  115235050001 044685404  SEVIGNY          SUSAN      18   21498708878          12/01/2022           1       $37.00       $0.77
      ACCTS                  115235050001 044685404  SEVIGNY          SUSAN      18   21498708878          12/01/2022           1       $20.79       $0.77
      ACCTS                  115235050001 044685404  SEVIGNY          SUSAN      18   21498708878          12/01/2022           1      $164.00       $0.78
      ACCTS                  115235050001 044685404  SEVIGNY          SUSAN      18   21498708878          12/01/2022           1      $273.00       $0.77
      ACCTS                  115235050001 044685404  SEVIGNY          SUSAN      18   21498708878          12/01/2022           1      $128.00       $0.77
      ACCTS                  115235050001 044685404  SEVIGNY          SUSAN      18   21498708878          12/01/2022           1       $25.00       $0.78
      ACCTS                  115235050001 044685404  SEVIGNY          SUSAN      18   21498708878          12/01/2022           1      $122.00       $0.77
      ACCTS                  115235050001 044685404  SEVIGNY          SUSAN      18   21498708878          12/01/2022           1       $41.97       $0.77
      ACCTS                  132434730001 115541873  GABEL            STEPHEN    18   22017696028          12/20/2022           1      $291.48       $8.59
      ACCTS                  132434730001 115541873  GABEL            STEPHEN    18   22017675297          12/23/2022           1      $154.72      $78.63
      ACCTS                  132434730001 115541873  GABEL            STEPHEN    18   22017697154          12/23/2022           1       $33.31       $9.81
      ACCTS                  132434730001 115541873  GABEL            STEPHEN    18   22017675297          12/23/2022           1        $8.22       $7.19
      ACCTS                  132434730001 115541873  GABEL            STEPHEN    18   22017675297          12/23/2022           1        $3.71       $1.08
      ACCTS                  132434730001 115541873  GABEL            STEPHEN    18   22017696028          12/20/2022           1      $484.28      $12.65
      ACCTS                  132434730001 115541873  GABEL            STEPHEN    18   22017696028          12/20/2022           2      $325.00       $9.30
      ACCTS                  132434730001 115541873  GABEL            STEPHEN    18   22017881096          12/27/2022           1      $353.11     $115.31
      ACCTS                  132434730001 115541873  GABEL            STEPHEN    18   22017697154          12/23/2022           1       $78.75      $28.57
      ACCTS                  132434730001 115541873  GABEL            STEPHEN    18   22017675297          12/23/2022           1      $102.38      $60.96
      ACCTS                  132434730001 115541873  GABEL            STEPHEN    18   22017696028          12/20/2022           1    $2,710.21   $1,629.64
      ACCTS                  132434730001 115541873  GABEL            STEPHEN    18   22017881096          12/27/2022           1      $141.62      $54.12
      ACCTS                  132434730001 115541873  GABEL            STEPHEN    18   22017697154          12/23/2022           1      $330.75      $82.84
      ACCTS                  132434730001 115541873  GABEL            STEPHEN    18   22017697154          12/23/2022           1       $27.09       $3.00
      ACCTS                  132434730001 115541873  GABEL            STEPHEN    18   22017982152          12/27/2022           1    $1,343.34     $564.53
      ACCTS                  132434730001 115541873  GABEL            STEPHEN    18   22017675018          12/28/2022           1      $218.59     $113.69

                                                                                                                                               PAGE:2 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      ACCTS                  132434730001 115541873  GABEL            STEPHEN    18   22017881000          12/29/2022           3      $117.00      $57.09
      ACCTS                  131796645001 166567635  DELONG           TAYLOR     19   21699115289          12/19/2022           1       $45.00      $34.31
      ACCTS                  110309048001 183449576  MCINTURFF        SUSAN      01   21898789283          12/28/2022           1       $40.00       $0.00
      ACCTS                  127519819001 238219163  FOUTZ            MELODY     18   21798682318          12/22/2022           1       $92.00       $3.09
      ACCTS                  127519819001 238219163  FOUTZ            MELODY     18   21798682318          12/22/2022           1      $187.00       $3.09
      ACCTS                  127520266001 485902979  MCBURNEY         CATHLEEN   01   21498006419          12/12/2022           1    $8,124.00   $5,850.50
      ACCTS                  127520266001 485902979  MCBURNEY         CATHLEEN   01   21498979214          12/27/2022           1       $42.74       $7.25
      ACCTS                  127520266001 485902979  MCBURNEY         CATHLEEN   01   21498982511          12/29/2022           1      $186.06      $74.06
      ACCTS                  127520266001 485902979  MCBURNEY         CATHLEEN   01   21498006419          12/12/2022           1       $66.15      $48.84
      ACCTS                  127520266001 485902979  MCBURNEY         CATHLEEN   01   21498006419          12/12/2022           1      $770.00     $555.62
      ACCTS                  127520266001 485902979  MCBURNEY         CATHLEEN   01   21498976919          12/27/2022           1       $27.69       $4.41
      ACCTS                  127520266001 485902979  MCBURNEY         CATHLEEN   01   21498978697          11/29/2022           1       $45.50       $7.58
      ACCTS                  127520266001 485902979  MCBURNEY         CATHLEEN   01   21498006419          12/12/2022           1       $60.00      $44.42
      ACCTS                  127520266001 485902979  MCBURNEY         CATHLEEN   01   21498976919          12/27/2022           1       $63.32       $8.59
      ACCTS                  127520266001 485902979  MCBURNEY         CATHLEEN   01   21498976919          12/27/2022           1       $45.50       $6.58
      ACCTS                  127520266001 485902979  MCBURNEY         CATHLEEN   01   21498006419          12/12/2022         100      $100.00      $73.22
      ACCTS                  127520266001 485902979  MCBURNEY         CATHLEEN   01   21498006419          12/12/2022           1    $6,060.00   $4,364.42
      ACCTS                  127520266001 485902979  MCBURNEY         CATHLEEN   01   21498976919          12/27/2022           1       $55.12       $5.81
      ACCTS                  127520266001 485902979  MCBURNEY         CATHLEEN   01   21498006419          12/12/2022          60      $180.00     $130.82
      ACCTS                  127520266001 485902979  MCBURNEY         CATHLEEN   01   21498006419          12/12/2022           1      $994.00     $716.90
      ACCTS                  127520266001 485902979  MCBURNEY         CATHLEEN   01   21498978697          11/29/2022           1       $88.07       $9.59
    ACCTS Total                                                                                                                     $24,807.47  $14,792.28
    ADM
        ADM                  101200918001 159503122  THOMAS           AMY        01   21498734839          12/28/2022           1      $110.00       $0.00
        ADM                  110260016001 165661412  BEITLER          CARYN      18   21898946568          12/27/2022           1      $102.00       $0.00
        ADM                  110260016001 165661412  BEITLER          CARYN      18   21898946568          12/27/2022           1      $196.00       $0.00
        ADM                  110260016001 165661412  BEITLER          CARYN      18   21898946568          12/27/2022           1      $166.00       $0.00
        ADM                  110260016001 165661412  BEITLER          CARYN      18   21898946568          12/27/2022           1    $2,791.00   $1,501.83
        ADM                  110260016001 165661412  BEITLER          CARYN      18   21898946568          12/27/2022           1      $347.00     $378.01
        ADM                  110260016001 165661412  BEITLER          CARYN      18   21898946568          12/27/2022           1      $671.00       $0.00
        ADM                  127519238001 166683164  SCHRUM           MADISON    19   21290501061          08/30/2022           1       $32.00      $21.21
        ADM                  127519238001 166683164  SCHRUM           MADISON    19   21290501061          08/30/2022           1       $20.00       $2.63

                                                                                                                                               PAGE:3 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
        ADM                  127519238001 166683164  SCHRUM           MADISON    19   21290501061          08/30/2022           1       $25.00      $10.96
        ADM                  127519238001 166683164  SCHRUM           MADISON    19   21290501061          08/30/2022           1       $40.00      $36.95
        ADM                  127519238001 166683164  SCHRUM           MADISON    19   21290501061          08/30/2022           2       $64.00      $32.03
        ADM                  127519238001 166683164  SCHRUM           MADISON    19   21290501061          08/30/2022           1      $185.00     $119.36
        ADM                  127519238001 166683164  SCHRUM           MADISON    19   21290501061          08/30/2022           1       $32.00      $21.21
        ADM                  127519238001 166683164  SCHRUM           MADISON    19   21290501061          08/30/2022           1       $70.00      $48.14
        ADM                  127519238001 166683164  SCHRUM           MADISON    19   21290501061          08/30/2022           1       $25.00      $12.08
        ADM                  127519548001 207720457  SABOLD           SAMANTHA   18   21698936636          12/27/2022           1      $105.00      $85.00
        ADM                  132273201001 214358541  JAMES            PENELOPE   19   21398291877          12/27/2022           1       $36.00      $24.36
        ADM                  132273201001 214358541  JAMES            PENELOPE   19   21398291877          12/27/2022           1       $40.00      $20.20
        ADM                  132273201001 214358541  JAMES            PENELOPE   19   21398291878          12/27/2022           1      $194.00      $96.31
        ADM                  132409589001 217350174  JAMISON          JOSHUA     18   21598402177          12/23/2022           2      $138.00      $57.06
        ADM                  132409589001 217350174  JAMISON          JOSHUA     18   21598402177          12/23/2022           1       $70.50      $24.58
        ADM                  135094145001 218190076  OLISCHUK         KRISTOPH   18   21598625391          12/28/2022           1      $170.00       $6.18
        ADM                  112385840001 218966856  PALMER           HEATHER    18   21598439869          12/22/2022           1      $144.00     $148.53
        ADM                  112385840001 218966856  PALMER           HEATHER    18   21598439869          12/22/2022           1      $181.00     $196.74
        ADM                  135727151001 484236994  MOODY            CHRISTOP   18   21598807813          12/22/2022           1       $48.00       $6.18
        ADM                  129151211001 530709866  SIMPSON          ASHLEY     19   21598772011          01/04/2023           1      $110.00       $0.00
        ADM                  133578700001 536845338  MOCK             FORREST    18   21798955034          12/29/2022           1      $208.00     $128.64
        ADM                  127520379001 590128028  DELOZIER         MICHELE    18   22017678844          12/30/2022           2       $90.00      $34.76
        ADM                  127520379001 590128028  DELOZIER         MICHELE    18   22017979682          01/04/2023           2      $100.00       $2.91
        ADM                  127520379001 590128028  DELOZIER         MICHELE    18   22017979682          01/04/2023           1       $45.00       $2.92
        ADM                  127520379001 590128028  DELOZIER         MICHELE    18   22017678844          12/30/2022           2      $100.00      $34.75
        ADM                  127520379001 590128028  DELOZIER         WILLIAM    01   22017973988          01/04/2023           1       $22.80       $5.83
        ADM                  127520379001 590128028  DELOZIER         ANNA       19   22017881734          01/02/2023           1      $160.00       $5.83
        ADM                  127520379001 590128028  DELOZIER         WILLIAM    01   22017676577          12/16/2022           1      $136.00     $100.66
        ADM                  129151216001 604266778  MARTINEZ DIAZ    ABIGAIL    18   21198491311          12/29/2022           1      $130.00       $0.00
        ADM                  129151216001 604266778  MARTINEZ DIAZ    ABIGAIL    18   21198491311          12/29/2022           1      $156.00       $0.00
        ADM                  120934323001 625703711  GRANT            ABIGAIL    19   22017982421          12/26/2022           1      $280.00      $83.53
        ADM                  120934323001 625703711  GRANT            LILIA      19   22017972790          12/22/2022           1      $315.00      $99.72
        ADM                  120934323001 625703711  GRANT            BROOKE     01   22017979244          12/26/2022           1      $280.00      $72.92
    ADM Total                                                                                                                        $8,135.30   $3,422.02

                                                                                                                                               PAGE:4 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
    ALTO
       ALTO                  101365685001 161585182  BARTLEY          LINDA      01   21899099597          12/08/2022           1      $163.00     $102.70
    ALTO Total                                                                                                                         $163.00     $102.70
    CKPT2
      CKPT2                  102952968001 181487050  BUNN             MATTHEW    18   21698767658          12/22/2022           1      $170.00      $89.13
      CKPT2                  102952968001 181487050  BUNN             MATTHEW    18   21698767658          12/22/2022           1       $48.00      $10.50
      CKPT2                  102952968001 181487050  BUNN             MATTHEW    18   21698767658          12/22/2022           1       $65.00      $33.10
      CKPT2                  134279041001 419986972  DICKERSON        VALERIE    01   21498626641          12/16/2022           2       $18.50       $6.60
      CKPT2                  134279041001 419986972  DICKERSON        VALERIE    01   21498626642          12/16/2022           1      $226.70     $135.36
    CKPT2 Total                                                                                                                        $528.20     $274.69
    CLARK
      CLARK                  104570479001 200709870  MISNER           DONALD     18   21197871413          12/15/2022           1      $268.00       $0.00
      CLARK                  104570479001 200709870  MISNER           DONALD     18   21197871413          12/15/2022           1    $1,529.00   $1,036.50
      CLARK                  104570479001 200709870  MISNER           DONALD     18   21197871413          12/15/2022           1      $696.00       $0.00
      CLARK                  104570479001 200709870  MISNER           DONALD     18   21197871413          12/15/2022           1       $64.20       $0.00
      CLARK                  104570479001 200709870  MISNER           DONALD     18   21197871413          12/15/2022           1      $153.00       $0.00
      CLARK                  135082887001 224930985  FEHER            JENNIFER   18   21699082751          12/31/2022           1      $119.00       $0.00
      CLARK                  135082887001 224930985  FEHER            JENNIFER   18   21699082751          12/31/2022           1       $49.00       $0.00
    CLARK Total                                                                                                                      $2,878.20   $1,036.50
    CLEVE
      CLEVE                  130492406001 287845251  HAMBLETON        ANGELLA    01   21298574132          12/13/2022           1      $570.00       $6.18
      CLEVE                  130492406001 287845251  HAMBLETON        HANNAH     19   21298850860          12/29/2022           1       $65.00       $6.18
    CLEVE Total                                                                                                                        $635.00      $12.36
    FESPLT
      FESPLT                 132900466001 366943817  RIORDAN          SEAN       18   21498704160          12/29/2022           1      $212.00     $165.73
      FESPLT                 132938865001 379331371  ASUNCION         ROMEO ED   19   22017680535          12/08/2022           1      $184.00     $179.85
      FESPLT                 132938865001 379331371  ASUNCION         ROMEO ED   19   22017680535          12/08/2022           1       $25.00      $18.56
    FESPLT Total                                                                                                                       $421.00     $364.14
    FLEET
      FLEET                  127519492001 199705451  LIPPY            KENSLEY    19   21498741945          12/29/2022           1       $45.50      $25.58
      FLEET                  127519492001 199705451  LIPPY            KENSLEY    19   21498741945          12/29/2022           1      $130.00       $0.00
      FLEET                  127519492001 199705451  LIPPY            KENSLEY    19   21498741945          12/29/2022           1       $32.00      $21.21

                                                                                                                                               PAGE:5 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
    FLEET Total                                                                                                                        $207.50      $46.79
    FORPK
      FORPK                  135274543001 258859772  HEARD            CHRISTOP   18   21799124370          12/29/2022           1       $74.25       $1.03
      FORPK                  135274543001 258859772  HEARD            CHRISTOP   18   21799124370          12/29/2022           1       $88.07       $1.03
      FORPK                  135274543001 258859772  HEARD            CHRISTOP   18   21799124370          12/29/2022           1       $47.59       $2.60
      FORPK                  135274543001 258859772  HEARD            CHRISTOP   18   21799124370          12/29/2022           1      $148.10      $10.07
      FORPK                  135274543001 258859772  HEARD            CHRISTOP   18   21799124370          12/29/2022           1       $50.62       $1.03
      FORPK                  135274543001 258859772  HEARD            CHRISTOP   18   21799124370          12/29/2022           1       $49.49       $1.03
    FORPK Total                                                                                                                        $458.12      $16.79
    GFPLT
      GFPLT                  134256187001 421020431  PEARSON          DARIUS     18   21198702861          12/21/2022           1       $58.00       $6.18
      GFPLT                  134256187001 421020431  PEARSON          DARIUS     18   21198702906          12/21/2022           1      $110.00       $6.18
    GFPLT Total                                                                                                                        $168.00      $12.36
    HCOMP
      HCOMP                  127520255001 452531358  NOBLE            RORY       19   21298480497          12/29/2022           1      $119.00       $0.00
      HCOMP                  127520255001 452531358  NOBLE            THEO       19   21298825270          01/03/2023           1      $135.00       $0.00
    HCOMP Total                                                                                                                        $254.00       $0.00
    HCSLS
      HCSLS                  134647659001 322086925  NEKRASOV         SERGEY     01   22017674056          10/26/2022           1       $40.00       $1.34
      HCSLS                  134647659001 322086925  NEKRASOV         SERGEY     01   22017977358          12/22/2022           1       $60.00       $1.33
      HCSLS                  134647659001 322086925  NEKRASOV         SERGEY     01   22017674056          10/26/2022           1       $60.00       $1.33
      HCSLS                  134647659001 322086925  NEKRASOV         DANIEL     19   22017682334          12/27/2022           1       $70.00       $1.33
      HCSLS                  134647659001 322086925  NEKRASOV         SERGEY     01   22017674327          12/27/2022           1       $40.00       $1.34
      HCSLS                  134647659001 322086925  NEKRASOV         SERGEY     01   22017977358          12/22/2022           1       $40.00       $1.34
      HCSLS                  134647659001 322086925  NEKRASOV         SERGEY     01   22017674056          10/26/2022           1       $70.00       $1.33
      HCSLS                  134647659001 322086925  NEKRASOV         SERGEY     01   22017674327          12/27/2022           1       $60.00       $1.33
      HCSLS                  134647659001 322086925  NEKRASOV         SERGEY     01   22017977358          12/22/2022           1       $70.00       $1.33
      HCSLS                  134647659001 322086925  NEKRASOV         SERGEY     01   22017683581          12/29/2022           1       $40.00       $1.34
      HCSLS                  134647659001 322086925  NEKRASOV         DANIEL     19   22017682334          12/27/2022           1       $60.00       $1.34
      HCSLS                  134647659001 322086925  NEKRASOV         SERGEY     01   22017977968          12/19/2022           1       $70.00       $1.33
      HCSLS                  134647659001 322086925  NEKRASOV         SERGEY     01   22017674327          12/27/2022           1       $70.00       $1.33
      HCSLS                  134647659001 322086925  NEKRASOV         SERGEY     01   22017683581          12/29/2022           1       $70.00       $1.33

                                                                                                                                               PAGE:6 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      HCSLS                  134647659001 322086925  NEKRASOV         SERGEY     01   22017683581          12/29/2022           1       $60.00       $1.33
      HCSLS                  134647659001 322086925  NEKRASOV         DANIEL     19   22017682334          12/27/2022           1       $40.00       $1.33
      HCSLS                  134647659001 322086925  NEKRASOV         SERGEY     01   22017977968          12/19/2022           1       $60.00       $1.33
      HCSLS                  134647659001 322086925  NEKRASOV         SERGEY     01   22017977968          12/19/2022           1       $40.00       $1.34
      HCSLS                  132228402001 526712360  SCHULTZ          JASON      01   21699112817          12/30/2022           1      $208.15       $4.00
    HCSLS Total                                                                                                                      $1,228.15      $28.00
    HOOK
       HOOK                  133919949001 004728959  CLEMENTS         KEVIN      18   21398574367          12/19/2022           1      $499.50     $164.61
    HOOK Total                                                                                                                         $499.50     $164.61
    INDY
       INDY                  129151187001 317062102  NEELY            MAEGEN     01   21897867418          12/10/2022           1       $71.00      $40.34
       INDY                  129151187001 317062102  NEELY            MAEGEN     01   21897777122          12/08/2022           1      $185.00     $137.38
       INDY                  129151187001 317062102  NEELY            MAEGEN     01   21897867418          12/10/2022           1      $190.00       $1.23
       INDY                  129151187001 317062102  NEELY            MAEGEN     01   21897867418          12/10/2022           1      $189.00     $105.33
       INDY                  129151187001 317062102  NEELY            MAEGEN     01   21874106795          12/15/2021           1      $120.00      $23.57
       INDY                  129151187001 317062102  NEELY            MAEGEN     01   21874106795          12/15/2021           1      $139.00       $2.06
       INDY                  129151187001 317062102  NEELY            MAEGEN     01   21897867418          12/10/2022           1       $31.00      $18.31
       INDY                  129151187001 317062102  NEELY            MAEGEN     01   21874106795          12/15/2021           1       $45.00       $2.06
       INDY                  129151187001 317062102  NEELY            MAEGEN     01   21897867418          12/10/2022           1      $185.00       $1.24
    INDY Total                                                                                                                       $1,155.00     $331.52
    INVAZ
      INVAZ                  127912560001 629844838  HERNANDEZ        ADRIANA    18   21699114796          12/05/2022           1      $231.00     $121.63
    INVAZ Total                                                                                                                        $231.00     $121.63
    INVIN
      INVIN                  128407144001 307922207  FOSS             MIYAH      19   21498973549          12/19/2022           1      $525.00     $105.56
      INVIN                  127920412001 312681131  PETTY            DAVID      18   21198434241          07/01/2022           1      $100.00      $54.40
      INVIN                  127920412001 312681131  PETTY            DAVID      18   21198434241          07/01/2022           1       $28.99      $26.55
      INVIN                  127920413001 312763959  COX              KRISTINE   18   21298573194          12/02/2022           1      $477.00     $206.18
      INVIN                  132547834001 313139464  CRUMP            KENDRA     18   21198598210          12/28/2022           1      $181.00      $65.14
      INVIN                  134557861001 317069291  LORTON           CASSI      18   21498706643          12/02/2022           1    $1,125.00     $363.18
      INVIN                  134557861001 317069291  LORTON           CASSI      18   21498706803          12/29/2022           1      $133.00      $65.14
      INVIN                  134557861001 317069291  LORTON           CASSI      18   21498709653          12/27/2022           1      $133.00      $61.02

                                                                                                                                               PAGE:7 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      INVIN                  134557861001 317069291  LORTON           CASSI      18   21498709653          12/27/2022           1       $47.00      $12.85
      INVIN                  134557861001 317069291  LORTON           CASSI      18   21498709653          12/27/2022           1       $12.00       $6.65
      INVIN                  134557861001 317069291  LORTON           CASSI      18   21498702657          12/28/2022           1       $86.00      $58.72
      INVIN                  134557861001 317069291  LORTON           CASSI      18   21498702657          12/28/2022           1      $118.00      $47.09
      INVIN                  128823862001 317982490  COUCH            WHITNEY    18   21498976255          12/23/2022           1    $2,499.00     $194.03
      INVIN                  128823862001 317982490  COUCH            WHITNEY    18   21498811596          12/23/2022           1    $1,859.00     $833.66
      INVIN                  128823862001 317982490  COUCH            WHITNEY    18   21498811596          12/23/2022           1      $328.00      $67.76
      INVIN                  128823862001 317982490  COUCH            WHITNEY    18   21498709073          11/29/2022           1      $200.00      $96.48
      INVIN                  128823862001 317982490  COUCH            WHITNEY    18   21498811596          12/23/2022           1      $358.00      $34.75
      INVIN                  128823862001 317982490  COUCH            WHITNEY    18   21498977001          12/23/2022           1    $1,895.00     $433.39
      INVIN                  128823862001 317982490  COUCH            WHITNEY    18   21498977001          12/23/2022           1    $3,332.00   $1,384.29
      INVIN                  131545332001 363963208  SCHMIDT          DREW       19   22017679704          12/27/2022           1       $44.00       $1.31
      INVIN                  131545332001 363963208  SCHMIDT          DREW       19   22017679704          12/27/2022           1       $44.00       $1.32
      INVIN                  131545332001 363963208  SCHMIDT          DREW       19   22017679704          12/27/2022           1      $253.00       $1.24
    INVIN Total                                                                                                                     $13,777.99   $4,120.71
    KCSLS
      KCSLS                  117690445001 340866590  HURT             KAI        19   21298403269          05/18/2022           1      $285.00       $0.00
      KCSLS                  117690445001 340866590  HURT             KAI        19   21298403269          05/18/2022           1       $65.00      $61.51
    KCSLS Total                                                                                                                        $350.00      $61.51
    KMPLT
      KMPLT                  134673767001 237555943  NORRIS           N KEIRA    19   21899237391          12/29/2022           1       $10.00       $3.09
      KMPLT                  134673767001 237555943  NORRIS           N KEIRA    19   21898961603          12/15/2022           1       $10.00       $6.18
      KMPLT                  134673767001 237555943  NORRIS           N KEIRA    19   21899237391          12/29/2022           1       $10.00       $3.09
    KMPLT Total                                                                                                                         $30.00      $12.36
    MKTG
       MKTG                  129442853001 366720182  GROOVER          CLARENCE   01   21298578519          12/27/2022           1      $318.00      $99.23
    MKTG Total                                                                                                                         $318.00      $99.23
    NASH
       NASH                  106901551001 295802636  LEMON            RODNEY     18   21198702816          12/28/2022           1      $357.00      $44.12
       NASH                  106901551001 295802636  LEMON            RODNEY     18   21198705059          12/28/2022           1    $2,314.00     $585.01
       NASH                  106901551001 295802636  LEMON            RODNEY     18   21198704674          12/28/2022           1    $2,314.00     $585.01
       NASH                  106901551001 295802636  LEMON            RODNEY     18   21198615639          12/28/2022           1    $7,211.00   $2,500.63

                                                                                                                                               PAGE:8 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       NASH                  106901551001 295802636  LEMON            RODNEY     18   21198702816          12/28/2022           1      $392.00     $127.52
       NASH                  106901551001 295802636  LEMON            RODNEY     18   21198615639          12/28/2022           1    $7,211.00   $1,327.62
       NASH                  106901551001 295802636  LEMON            RODNEY     18   21198615639          12/28/2022           1      $518.70      $13.37
       NASH                  106901551001 295802636  LEMON            RODNEY     18   21198615639          12/28/2022           1    $4,474.00     $722.30
    NASH Total                                                                                                                      $24,791.70   $5,905.58
    PLT18
      PLT18                  133920038001 418154694  MURRAY           JOSEPH     18   21298581309          12/07/2022           1      $145.00     $139.86
    PLT18 Total                                                                                                                        $145.00     $139.86
    PLT2
       PLT2                  110028435001 166600460  BELL             THOMAS     18   21699274156          12/16/2022           1      $172.00     $118.88
       PLT2                  127519664001 218761650  GROSS            KAYLEE     19   21598788519          01/04/2023           1      $135.00       $0.00
       PLT2                  127519664001 218761650  GROSS            KAYLEE     19   21598788519          01/04/2023           1       $40.00       $0.00
       PLT2                  127519677001 219924174  REISINGER        JANE       18   22017314465          12/23/2022           1       $95.00      $57.18
       PLT2                  127519677001 219924174  REISINGER        JANE       18   22017314465          12/23/2022           1      $110.00      $85.70
    PLT2 Total                                                                                                                         $552.00     $261.76
    PLT3
       PLT3                  123899451001 196486705  TREADWAY         DENNIS     18   21698839515          12/23/2022           1        $1.65       $0.00
       PLT3                  123899451001 196486705  TREADWAY         DENNIS     18   21698839515          12/23/2022           1      $698.00     $582.88
       PLT3                  123899451001 196486705  TREADWAY         DENNIS     18   21698839515          12/22/2022           1      $331.00       $0.00
       PLT3                  123899451001 196486705  TREADWAY         DENNIS     18   21698839515          12/23/2022           2      $288.00     $228.05
       PLT3                  123899451001 196486705  TREADWAY         DENNIS     18   21698839515          12/23/2022           1        $1.90       $0.00
       PLT3                  123899451001 196486705  TREADWAY         DENNIS     18   21698839515          12/22/2022           1    $1,529.00   $1,045.63
       PLT3                  123899451001 196486705  TREADWAY         DENNIS     18   21698839515          12/22/2022           1       $56.00       $0.00
       PLT3                  123899451001 196486705  TREADWAY         DENNIS     18   21698839515          12/23/2022           8        $6.50       $0.00
       PLT3                  123899451001 196486705  TREADWAY         DENNIS     18   21698839515          12/22/2022           1       $90.00       $0.00
       PLT3                  123899451001 196486705  TREADWAY         DENNIS     18   21698839515          12/22/2022           1       $78.00       $0.00
       PLT3                  135327684001 216390293  BOONE            KASEY      18   21398644749          12/30/2022           1      $114.00       $0.00
       PLT3                  127519668001 218927984  DODSON           ASHLEY     01   22015525952          11/26/2022           1    $2,598.00     $655.62
       PLT3                  127519668001 218927984  DODSON           ASHLEY     01   22015525952          11/26/2022           1       $56.00       $0.00
       PLT3                  127519668001 218927984  DODSON           ASHLEY     01   22015525952          11/26/2022           1      $698.00     $582.88
       PLT3                  127519668001 218927984  DODSON           ASHLEY     01   22015525952          11/26/2022           1        $1.90       $0.00
       PLT3                  127519668001 218927984  DODSON           ASHLEY     01   22015525952          11/26/2022           1       $89.00       $0.00

                                                                                                                                               PAGE:9 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT3                  127519668001 218927984  DODSON           ASHLEY     01   22015525952          11/26/2022           1       $49.00       $0.00
       PLT3                  127519668001 218927984  DODSON           ASHLEY     01   22015525952          11/26/2022           1       $24.00       $0.00
       PLT3                  127519668001 218927984  DODSON           ASHLEY     01   22015525952          11/26/2022           1       $98.00       $0.00
       PLT3                  127519668001 218927984  DODSON           ASHLEY     01   22015525952          11/26/2022           1    $1,529.00   $1,036.50
       PLT3                  133037780001 227297009  VON HUSEN        MICHAEL    18   21598609620          12/30/2022           1       $40.00      $32.00
       PLT3                  127519924001 266598591  ARNDT            TIMOTHY    18   21498266431          12/20/2022           1       $15.00       $0.00
       PLT3                  127519924001 266598591  ARNDT            TIMOTHY    18   21498266431          12/20/2022           1       $55.00       $0.00
       PLT3                  127519924001 266598591  ARNDT            TIMOTHY    18   21498266431          12/20/2022           1       $37.00       $0.00
       PLT3                  127519924001 266598591  ARNDT            TIMOTHY    18   21498673232          12/23/2022           1    $1,109.00       $0.00
       PLT3                  127519924001 266598591  ARNDT            TIMOTHY    18   21498673203          12/23/2022           1    $2,664.00       $0.00
       PLT3                  127519924001 266598591  ARNDT            TIMOTHY    18   21498266431          12/20/2022           1       $68.00       $0.00
       PLT3                  127519924001 266598591  ARNDT            TIMOTHY    18   21498266431          12/20/2022           1      $393.00       $0.00
       PLT3                  127519924001 266598591  ARNDT            TIMOTHY    18   21498673233          12/23/2022           1      $221.80       $0.00
       PLT3                  130008010001 597501729  LOPEZ ALMANZA    ALAIA      19   21498876815          12/13/2022           1       $24.00      $24.00
       PLT3                  130008010001 597501729  LOPEZ ALMANZA    ALAIA      19   21498876815          12/13/2022           1       $24.00      $20.20
       PLT3                  130008010001 597501729  LOPEZ ALMANZA    ALAIA      19   21498876815          12/13/2022           1       $24.00      $24.00
       PLT3                  130008010001 597501729  LOPEZ ALMANZA    ALAIA      19   21498876815          12/13/2022           1       $24.00      $24.00
       PLT3                  130008010001 597501729  LOPEZ ALMANZA    ALAIA      19   21498876816          12/13/2022           1      $182.00      $90.98
       PLT3                  130008010001 597501729  LOPEZ ALMANZA    ALAIA      19   21498876815          12/13/2022           1       $10.00      $10.00
       PLT3                  130008010001 597501729  LOPEZ ALMANZA    ALAIA      19   21498876815          12/13/2022           1       $10.00      $10.00
       PLT3                  132527776001 598345140  PLAZA BARTOLOMEI STEPHANI   18   21498976342          11/23/2022           1      $344.00     $127.05
       PLT3                  133287955001 599706977  ORTEGA FERNANDEZ BRYAN      18   21780408408          02/24/2022           1       $91.00      $47.80
       PLT3                  127520404001 603224331  MARTINEZ SALAZAR PABLO      18   21798824515          12/30/2022           1       $77.00      $57.18
       PLT3                  127520404001 603224331  MARTINEZ SALAZAR PABLO      18   21798824515          12/30/2022           1      $154.00      $90.10
       PLT3                  133599164001 639465337  LOZADA           JOSEFINA   18   21598599733          12/28/2022           1       $34.00      $17.97
       PLT3                  133599164001 639465337  LOZADA           JOSEFINA   18   21598589252          11/29/2022           1      $141.00      $66.94
       PLT3                  133599164001 639465337  LOZADA           JOSEFINA   18   21598599733          12/28/2022           1       $15.00       $0.00
       PLT3                  135954257001 646098876  EDLER            JENIFER    18   21598168918          12/23/2022           1      $195.00      $90.10
       PLT3                  135954257001 646098876  EDLER            JENIFER    18   21598168918          12/23/2022           1       $49.00      $30.00
    PLT3 Total                                                                                                                      $14,337.75   $4,893.88
    PLT4
       PLT4                  100244188001 050601243  PACHECO          MIGDALIA   18   21198768591          10/27/2022           1      $563.00       $0.00

                                                                                                                                              PAGE:10 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT4                  100244188001 050601243  PACHECO          MIGDALIA   18   21198768591          10/27/2022           1       $15.00       $0.00
       PLT4                  100244188001 050601243  PACHECO          MIGDALIA   18   21198768591          10/27/2022           1       $55.00       $0.00
       PLT4                  101765356001 166669715  RUPPERT          BRIAN      18   21798927865          12/30/2022           1       $49.00       $0.00
       PLT4                  101765356001 166669715  RUPPERT          BRIAN      18   21798927865          12/30/2022           1      $119.00       $0.00
       PLT4                  134847595001 198529565  BIRGENSMITH      TRACY      18   21198577773          12/27/2022           1      $111.00       $0.00
       PLT4                  134847595001 198529565  BIRGENSMITH      TRACY      18   21198577773          12/27/2022           1       $15.00       $0.00
       PLT4                  134847595001 198529565  BIRGENSMITH      TRACY      18   21198577773          12/27/2022           1      $247.00       $0.00
       PLT4                  134847595001 198529565  BIRGENSMITH      TRACY      18   21198577773          12/27/2022           1       $90.00       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           1    $9,011.50  $27,799.68
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           1       $46.75       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022          66      $808.50       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           4       $33.25       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/21/2022           2        $3.25       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398292021          12/20/2022           1      $440.80      $99.42
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           3      $114.00       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           3      $786.00       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           3    $3,861.00       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           1    $1,334.58       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398292020          12/20/2022           1       $87.00      $14.68
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398437268          12/20/2022           1    $2,952.00     $339.25
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           1    $3,826.00       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           2      $246.00       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398292020          12/20/2022           1      $953.00     $194.46
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           1       $17.00       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           1    $4,505.75       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           2       $41.00       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/21/2022          24    $1,344.00       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           4       $27.75       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398292020          12/20/2022           1      $306.00     $126.08
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           1    $1,676.75       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           1       $47.50       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022          15       $29.25       $0.00

                                                                                                                                              PAGE:11 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398292020          12/20/2022           1    $2,204.00     $860.02
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           1       $14.00       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/21/2022           4       $81.00       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           1       $46.75       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/21/2022           1        $3.25       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           6        $9.75       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           4    $1,652.00       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           4       $81.00       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           1       $28.25       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           4       $81.00       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/21/2022           1       $46.75       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           1      $459.00       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           6    $2,160.00       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           1       $18.25       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022           1    $4,505.75       $0.00
       PLT4                  112355283001 205520610  GUIHER           DEBORAH    01   21398289996          12/20/2022          24    $1,998.00       $0.00
       PLT4                  131666105001 209680310  CHRONISTER       LYNN       01   21298480458          12/29/2022           1       $49.00       $0.00
       PLT4                  131666105001 209680310  CHRONISTER       LYNN       01   21298480458          12/29/2022           1      $277.00       $0.00
       PLT4                  130624465001 500756604  SOTO             MARIA      18   21498609027          12/28/2022           1      $197.00     $102.69
       PLT4                  129907882001 596106308  MARTE BATISTA    MISAEL     19   21198770530          01/03/2023           1      $119.00       $0.00
       PLT4                  129907882001 596106308  MARTE BATISTA    MISAEL     19   21198770530          01/03/2023           1       $49.00       $0.00
    PLT4 Total                                                                                                                      $47,842.38  $29,536.28
    PLT5
       PLT5                  127519295001 173725544  TRENT            AARON      19   21598589159          11/22/2022           2      $154.00      $62.98
       PLT5                  127519295001 173725544  TRENT            AARON      19   21598589159          11/22/2022           1       $77.00      $34.98
       PLT5                  127519295001 173725544  TRENT            AARON      19   21598589159          11/22/2022           1      $178.00      $94.46
       PLT5                  127519295001 173725544  TRENT            AARON      19   21598589159          11/22/2022           3      $408.00     $210.72
       PLT5                  103138317001 183664912  DELL             VICKY      01   22017645407          12/30/2022           1       $14.00       $0.00
       PLT5                  103138317001 183664912  DELL             VICKY      01   22017645407          12/30/2022           1      $105.00      $85.00
       PLT5                  103138317001 183664912  DELL             TYLER      19   22017026883          10/19/2022           1       $35.00      $14.73
    PLT5 Total                                                                                                                         $971.00     $502.87
    PLTAD

                                                                                                                                              PAGE:12 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      PLTAD                  134753379001 076863776  BERJAOUI         AFAF       18   21698950702          12/22/2022           1       $66.00       $0.45
      PLTAD                  134753379001 076863776  BERJAOUI         AFAF       18   21698950702          12/22/2022           1       $31.00       $0.45
      PLTAD                  134753379001 076863776  BERJAOUI         AFAF       18   21698950702          12/22/2022           1      $219.00       $0.44
      PLTAD                  134753379001 076863776  BERJAOUI         AFAF       18   21698950702          12/22/2022           1      $117.00       $0.44
      PLTAD                  134753379001 076863776  BERJAOUI         AFAF       18   21698950702          12/22/2022           1      $181.00       $0.44
      PLTAD                  134753379001 076863776  BERJAOUI         AFAF       18   21698950702          12/22/2022           1       $98.00       $0.45
      PLTAD                  134753379001 076863776  BERJAOUI         AFAF       18   21698950702          12/22/2022           1       $99.23       $0.45
      PLTAD                  134753379001 076863776  BERJAOUI         AFAF       18   21698950702          12/22/2022           1      $101.77       $0.44
      PLTAD                  134753379001 076863776  BERJAOUI         AFAF       18   21698950702          12/22/2022           1      $273.00       $0.44
      PLTAD                  128489398001 093827219  COPE             MELANIE    18   21799022728          01/03/2023           1      $126.00     $102.00
      PLTAD                  114958995001 171668102  MOZDZEN          MIKAELA    19   21698769837          12/22/2022           1       $35.00       $0.00
      PLTAD                  114958995001 171668102  MOZDZEN          MIKAELA    19   21698769837          12/22/2022           1       $35.00       $0.00
      PLTAD                  114958995001 171668102  MOZDZEN          MIKAELA    19   21698769837          12/22/2022           1      $100.00       $0.00
      PLTAD                  126024764001 184720674  SCUTTA           CODY       18   21598504803          12/22/2022           1      $542.00     $822.58
      PLTAD                  126024764001 184720674  SCUTTA           CODY       18   21598777792          12/28/2022           1    $1,115.00     $413.31
      PLTAD                  126024764001 184720674  SCUTTA           CODY       18   21598504803          12/22/2022           1    $1,973.00   $1,130.94
      PLTAD                  126024764001 184720674  SCUTTA           CODY       18   21598504803          12/22/2022           1      $388.00     $595.67
      PLTAD                  103512656001 188408797  MUMMERT          SCOTT      18   21298748147          01/03/2023           1       $67.00      $40.00
    PLTAD Total                                                                                                                      $5,567.00   $3,108.50
    RETAI
      RETAI                  133119475001 216024769  BUCZYNSKI        GINA       18   21798478058          12/19/2022           1      $430.00       $0.00
      RETAI                  133119475001 216024769  BUCZYNSKI        GINA       18   21798478058          12/19/2022           1      $235.00       $0.00
      RETAI                  133119475001 216024769  BUCZYNSKI        GINA       18   21798478058          12/19/2022           1      $424.00       $0.00
    RETAI Total                                                                                                                      $1,089.00       $0.00
    RWPLT
      RWPLT                  128659727001 592131186  LAGE             ALFONSO    18   21298408942          12/16/2022           1       $49.00      $19.62
      RWPLT                  128659727001 592131186  LAGE             ALFONSO    18   21298408867          12/16/2022           1       $49.00      $19.62
      RWPLT                  128659727001 592131186  LAGE             ALFONSO    18   21298160450          12/16/2022           1    $3,126.00   $1,517.44
      RWPLT                  128659727001 592131186  LAGE             ALFONSO    18   21298160450          12/16/2022           1      $102.00      $50.36
      RWPLT                  128659727001 592131186  LAGE             ALFONSO    18   21298160450          12/16/2022           1      $222.00     $108.58
      RWPLT                  128659727001 592131186  LAGE             ALFONSO    18   21298408942          12/16/2022           1    $1,022.00     $331.27
      RWPLT                  128659727001 592131186  LAGE             ALFONSO    18   21298408867          12/16/2022           1    $1,290.00     $424.97

                                                                                                                                              PAGE:13 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      RWPLT                  128659727001 592131186  LAGE             ALFONSO    18   21298160450          12/16/2022           1      $358.00     $174.57
      RWPLT                  128659727001 592131186  LAGE             ALFONSO    18   21298160450          12/16/2022           1        $5.25       $3.43
      RWPLT                  128659727001 592131186  LAGE             ALFONSO    18   21298160450          12/16/2022           1       $44.00      $22.24
      RWPLT                  128659727001 592131186  LAGE             ALFONSO    18   21298160450          12/16/2022           1       $57.00      $28.54
      RWPLT                  128659727001 592131186  LAGE             ALFONSO    18   21298160450          12/16/2022           1      $415.00     $202.23
      RWPLT                  128659727001 592131186  LAGE             ALFONSO    18   21298160450          12/16/2022           1      $158.00      $77.53
      RWPLT                  128659727001 592131186  LAGE             ALFONSO    18   21298160450          12/16/2022         100   $21,025.00  $12,358.19
      RWPLT                  128659727001 592131186  LAGE             ALFONSO    18   21298160450          12/16/2022           1      $160.00      $78.51
    RWPLT Total                                                                                                                     $28,082.25  $15,417.10
    SBSLS
      SBSLS                  131796640001 118603001  GALLAHER         JOHN       18   21198489084          12/15/2022           1       $55.00       $0.00
      SBSLS                  131796640001 118603001  GALLAHER         JOHN       18   21198576843          12/28/2022           1    $1,749.00     $457.79
      SBSLS                  131796640001 118603001  GALLAHER         JOHN       18   21198489084          12/15/2022           1      $165.00       $0.00
      SBSLS                  131796640001 118603001  GALLAHER         JOHN       18   21198489084          12/15/2022           1       $10.00       $0.00
      SBSLS                  131796640001 118603001  GALLAHER         JOHN       18   21198576843          12/28/2022           1      $298.35       $0.00
    SBSLS Total                                                                                                                      $2,277.35     $457.79
    SLSUP
      SLSUP                  117749120001 181724326  JORDAN           BENNETT    19   21598523971          12/29/2022           1       $81.00       $0.00
      SLSUP                  109977359001 202587914  STRAUSBAUGH      JESSICA    01   21598506700          12/27/2022           1       $37.00       $0.00
      SLSUP                  127900343001 429695148  COLLINS          SHANNON    18   21298576606          12/23/2022           1      $180.00     $162.16
      SLSUP                  127900343001 429695148  COLLINS          SHANNON    18   21298576606          12/23/2022           1      $200.00       $2.00
      SLSUP                  132228410001 640426345  HERNANDEZ        SONIA      18   21598617312          12/29/2022           1      $467.63       $4.00
      SLSUP                  132228410001 640426345  HERNANDEZ        SONIA      18   21598624234          12/30/2022           1      $264.81       $4.00
      SLSUP                  132228410001 640426345  HERNANDEZ        SONIA      18   21598894968          12/31/2022           1      $264.81       $4.00
    SLSUP Total                                                                                                                      $1,495.25     $176.16
    TMPLT
      TMPLT                  133319548001 574134459  HUNSLEY          ALANNAH    18   21198786540          12/19/2022           1      $291.50       $2.06
      TMPLT                  133319548001 574134459  HUNSLEY          ALANNAH    18   21198786540          12/19/2022           1      $291.50       $2.06
      TMPLT                  133319548001 574134459  HUNSLEY          ALANNAH    18   21198786540          12/19/2022           1      $142.50       $2.06
    TMPLT Total                                                                                                                        $725.50       $6.18
    TMSLS
      TMSLS                  130351361001 478826881  ESSER            KANDACE    01   21598621791          12/21/2022           1      $694.25     $237.61

                                                                                                                                              PAGE:14 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      TMSLS                  130351361001 478826881  ESSER            KANDACE    01   21598621791          12/21/2022           1      $853.75     $579.26
      TMSLS                  130351361001 478826881  ESSER            KANDACE    01   21598622485          12/21/2022           1      $211.25     $136.30
      TMSLS                  130351361001 478826881  ESSER            KANDACE    01   21598621791          12/21/2022           1      $197.25      $63.79
      TMSLS                  130351361001 478826881  ESSER            KANDACE    01   21598623428          09/06/2022           1    $1,463.06     $570.97
      TMSLS                  130351361001 478826881  ESSER            WILLIAM    18   21597924759          12/14/2022           1      $150.00       $6.18
    TMSLS Total                                                                                                                      $3,569.56   $1,594.11
    WILSO
      WILSO                  127519833001 239497207  TYNDALL          REBECCA    01   21398058154          12/14/2022           1       $29.00       $6.17
      WILSO                  127519833001 239497207  TYNDALL          REBECCA    01   21398058154          12/14/2022           1       $25.00       $5.69
      WILSO                  127519833001 239497207  TYNDALL          REBECCA    01   21398058154          12/14/2022           1      $137.00      $32.12
      WILSO                  127519833001 239497207  TYNDALL          REBECCA    01   21398058154          12/14/2022           1       $17.00       $4.08
    WILSO Total                                                                                                                        $208.00      $48.06
    ZALA
       ZALA                  110000391001 416944310  DAVIS            KENNETH    18   21699220120          12/30/2022           1      $173.00       $5.58
    ZALA Total                                                                                                                         $173.00       $5.58
     
                             136316417001 125482097  FRIEDMAN         JACK       19   21598895239          01/03/2023           1       $42.00       $4.00
                             112157564001 595662434  COSTANTINI       ALFRED     19   21598896743          01/04/2023           1       $20.00       $0.67
                             112157564001 595662434  COSTANTINI       ALFRED     19   21598896743          01/04/2023           1       $42.00       $0.67
                             112157564001 595662434  COSTANTINI       ALFRED     19   21598896743          01/04/2023           1       $20.00       $0.67
                             112157564001 595662434  COSTANTINI       ALFRED     19   21598896743          01/04/2023           1      $170.00     $166.28
                             112157564001 595662434  COSTANTINI       ALFRED     19   21598896743          01/04/2023           1       $32.00      $22.99
                             112157564001 595662434  COSTANTINI       ALFRED     19   21598896876          01/04/2023           1        $7.50       $9.28
                             112157564001 595662434  COSTANTINI       ALFRED     19   21598896743          01/04/2023           1       $25.00       $0.66
                             133360904001 833857884  SOK              KIMLENG    18   21298709334          01/03/2023           1      $265.00       $0.00
      Total                                                                                                                            $623.50     $205.22
  025620-00 Total                                                                                                                  $188,695.67  $87,279.13
  025620-70
    COBRA
      COBRA                  127535891001 203627627  LAWRENCE         HOLLY      01   21598182817          12/19/2022           1      $279.00     $122.79
      COBRA                  127535891001 203627627  LAWRENCE         HOLLY      01   21598182817          12/19/2022           1      $270.00      $92.70
    COBRA Total                                                                                                                        $549.00     $215.49

                                                                                                                                              PAGE:15 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
  025620-70 Total                                                                                                                      $549.00     $215.49
HDHP PPO Total                                                                                                                     $189,244.67  $87,494.62
                                                                                                                                                            
PPO
  025620-01
    ACCTS
      ACCTS                  128566801001 151622789  SPENCER          KEARA      19   21198599487          12/22/2022           1    $1,498.00     $703.15
      ACCTS                  128566801001 151622789  SPENCER          KOLBIE     19   21198702068          12/19/2022           1       $80.00      $65.66
      ACCTS                  102541615001 176466738  JACOBS           RICHARD    18   21798411935          12/21/2022           1      $139.00      $67.57
      ACCTS                  102541615001 176466738  JACOBS           RICHARD    18   21798411935          12/21/2022           1      $125.00      $46.85
      ACCTS                  102541615001 176466738  JACOBS           RICHARD    18   21798411935          12/21/2022           1       $98.00       $0.00
      ACCTS                  102541615001 176466738  JACOBS           RICHARD    18   21798411935          12/21/2022           1       $56.00      $27.18
      ACCTS                  102541615001 176466738  JACOBS           RICHARD    18   21798411935          12/21/2022           1       $10.00       $0.00
      ACCTS                  131796660001 218475087  NEIDERER         CREW       19   21398135988          12/22/2022           1      $130.00      $89.99
      ACCTS                  131796660001 218475087  NEIDERER         CREW       19   21398135988          12/22/2022           1      $150.00      $60.04
      ACCTS                  131796660001 218475087  NEIDERER         CREW       19   21398135988          12/22/2022           1      $175.50      $70.88
      ACCTS                  127519998001 300741357  HOGSED           NOAH       19   21699221099          01/02/2023           1      $200.00       $6.18
      ACCTS                  127519998001 300741357  STANCEL          MICHELLE   01   21699117004          12/27/2022           1      $190.00      $29.88
      ACCTS                  135654650001 408297455  ROBERTS          RAYMOND    18   21898968513          11/28/2022           1      $204.00       $4.97
      ACCTS                  135654650001 408297455  ROBERTS          RAYMOND    18   21898968513          11/28/2022           1      $398.75       $8.76
      ACCTS                  109915959001 426415597  LOVETT           DONALD     18   21398466904          12/16/2022           1       $59.00      $27.18
    ACCTS Total                                                                                                                      $3,513.25   $1,208.29
    ADM
        ADM                  134373697001 110642727  GRANJA           MERVIL     18   21798432999          12/18/2022           1      $250.00      $26.50
        ADM                  134373697001 110642727  GRANJA           MERVIL     18   21798849428          11/15/2022           1      $245.00     $246.50
        ADM                  134373697001 110642727  GRANJA           MERVIL     18   21798432999          12/18/2022           1      $100.00     $101.50
        ADM                  134373697001 110642727  GRANJA           MERVIL     18   21798848872          12/25/2022           1      $250.00     $251.50
        ADM                  134373697001 110642727  GRANJA           MERVIL     18   21798849428          11/15/2022           1      $100.00     $101.50
        ADM                  134373697001 110642727  GRANJA           MERVIL     18   21798848872          12/25/2022           1      $100.00     $101.50
        ADM                  127519157001 135628506  BRICK            KAITLYN    19   21298544482          12/27/2022           1      $212.00     $124.00
        ADM                  102127457001 171429639  GARRETT          DEAN       18   21298612627          12/28/2022           1       $25.00      $17.93
        ADM                  102127457001 171429639  GARRETT          DEAN       18   21298612627          12/28/2022           1       $50.00      $26.66

                                                                                                                                              PAGE:16 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
        ADM                  118293406001 172663018  MESSINGER        ELSIE      19   21798479595          12/14/2022           2      $190.00      $19.87
        ADM                  132434731001 173662391  ELICKER          RACHEL     19   21198577844          12/19/2022           1      $131.00       $0.00
        ADM                  132434731001 173662391  ELICKER          RACHEL     19   21198577844          12/19/2022           1       $96.00       $0.00
        ADM                  132434731001 173662391  ELICKER          LAUREN     19   21198571737          12/27/2022           1      $102.00     $102.00
        ADM                  132434731001 173662391  ELICKER          RACHEL     19   21198577844          12/19/2022           1       $55.00       $0.00
        ADM                  132434731001 173662391  ELICKER          RACHEL     19   21198577844          12/19/2022           1       $86.00       $0.00
        ADM                  132434731001 173662391  ELICKER          RACHEL     19   21198577844          12/19/2022           1       $45.00       $0.00
        ADM                  132434731001 173662391  ELICKER          RACHEL     19   21198577844          12/19/2022           1       $91.00       $0.00
        ADM                  132434731001 173662391  ELICKER          RACHEL     19   21198577844          12/19/2022           1       $15.00       $0.00
        ADM                  132434731001 173662391  ELICKER          RACHEL     19   21198577844          12/19/2022           1      $340.00     $369.25
        ADM                  132434731001 173662391  ELICKER          LAUREN     19   21198577256          12/27/2022           1      $439.00     $406.81
        ADM                  132434731001 173662391  ELICKER          RACHEL     19   21198577844          12/19/2022           1       $54.00       $0.00
        ADM                  132317941001 190582861  DUGAN            TINA       18   21498602026          12/27/2022           1        $0.50       $0.15
        ADM                  132317941001 190582861  DUGAN            MICHAEL    01   21498827429          12/29/2022           1      $469.77      $66.00
        ADM                  132317941001 190582861  DUGAN            TINA       18   21498602026          12/27/2022           1       $77.00      $57.18
        ADM                  132317941001 190582861  DUGAN            TINA       18   21498602026          12/27/2022           1      $376.00     $134.19
        ADM                  132317941001 190582861  DUGAN            TINA       18   21498742035          12/27/2022           1       $25.00      $22.41
        ADM                  132317941001 190582861  DUGAN            TINA       18   21498742035          12/27/2022           1       $50.00      $33.32
        ADM                  132317941001 190582861  DUGAN            TINA       18   21498601959          12/27/2022           1       $45.00      $34.65
        ADM                  132317941001 190582861  DUGAN            MICHAEL    01   21498827429          12/29/2022           1      $186.14      $44.80
        ADM                  132317941001 190582861  DUGAN            TINA       18   21498602026          12/27/2022           1       $43.00      $12.67
        ADM                  104064952001 194606883  MINSINGER        SELENE     01   21498431519          12/22/2022           1      $125.00     $179.55
        ADM                  104064952001 194606883  MINSINGER        SELENE     01   21498431519          12/22/2022           1    $1,131.00     $499.14
        ADM                  104064952001 194606883  MINSINGER        SELENE     01   21498514319          12/28/2022           1      $251.00      $85.81
        ADM                  104071620001 194661813  FEESER           AMY        18   21398606155          11/29/2022           1      $148.10      $13.00
        ADM                  104071620001 194661813  FEESER           AMY        18   21398606155          11/29/2022           1       $74.25       $0.00
        ADM                  104071620001 194661813  FEESER           AMY        18   21398606155          11/29/2022           1      $264.06       $0.00
        ADM                  104269919001 197340692  KLEIN            DOROTHY    01   21598793364          12/30/2022           1      $180.00      $70.81
        ADM                  104310230001 197582859  BYNAKER          TYLER      19   21598425899          12/23/2022           1        $7.50       $3.25
        ADM                  104310230001 197582859  BYNAKER          TYLER      19   21598425899          12/23/2022         750    $2,077.50     $975.00
        ADM                  104310230001 197582859  BYNAKER          TYLER      19   21598425899          12/23/2022           1      $163.40      $93.40
        ADM                  115186244001 198669259  FENNER           LIAM       19   21598854301          12/07/2022           4      $264.00     $350.90

                                                                                                                                              PAGE:17 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
        ADM                  115186244001 198669259  FENNER           LIAM       19   21598271929          12/12/2022           4      $140.00      $50.40
        ADM                  112385669001 201683406  WISE             TAMMY      18   21597665475          12/05/2022          60    $5,356.80   $2,379.60
        ADM                  105772205001 219945034  SNYDER           ROXANNE    18   21298564843          12/31/2022           1       $40.00       $5.00
        ADM                  114833354001 311702430  METZGER          DEBRA      01   21598805223          01/01/2023           1       $32.00       $6.18
        ADM                  132228392001 320748994  PANIAGUA         KATHRINE   18   21598808983          12/22/2022           1      $150.00     $154.00
        ADM                  132459774001 349563167  JUAREZ           LISA       01   21699219752          12/14/2022           1      $165.00     $115.75
        ADM                  132459777001 350644562  PALIOKAITIS      PATRICIA   18   22017246813          12/19/2022           1       $90.00      $37.07
        ADM                  132459777001 350644562  PALIOKAITIS      PATRICIA   18   22017975257          12/16/2022           1       $19.00      $15.39
        ADM                  132459777001 350644562  PALIOKAITIS      PATRICIA   18   22017975257          12/16/2022           1       $15.00       $2.00
        ADM                  132459777001 350644562  PALIOKAITIS      PATRICIA   18   22017246813          12/19/2022           1       $10.00       $9.46
        ADM                  132459777001 350644562  PALIOKAITIS      PATRICIA   18   22017246813          12/19/2022           1      $220.00     $163.02
        ADM                  132736780001 400112551  HARPER           TAMMY      01   21198615094          12/05/2022           1      $150.00      $47.20
        ADM                  135617005001 424239396  THIGPEN          CURTIS     18   21198785826          12/30/2022           1       $88.07       $2.06
        ADM                  135617005001 424239396  THIGPEN          CURTIS     18   21198785826          12/30/2022           1       $45.50       $2.06
        ADM                  135617005001 424239396  THIGPEN          CURTIS     18   21198785826          12/30/2022           1      $148.10       $2.06
        ADM                  132684100001 424419143  RUSSELL          ALFRED     18   21799128138          01/02/2023           1      $115.00      $22.68
        ADM                  132684100001 424419143  RUSSELL          ALFRED     18   21798954288          12/29/2022           1      $265.00     $160.60
        ADM                  132684100001 424419143  RUSSELL          ALFRED     18   21799119582          12/31/2022           3       $30.00      $18.43
        ADM                  132684100001 424419143  RUSSELL          ALFRED     18   21799119582          12/31/2022           1      $145.00      $29.94
        ADM                  132684100001 424419143  RUSSELL          ALFRED     18   21799119582          12/31/2022           1       $20.00      $17.35
        ADM                  132684100001 424419143  RUSSELL          ALFRED     18   21799036773          01/03/2023           1       $97.00      $18.93
        ADM                  132142483001 444980697  MCDONIEL         JESSICA    18   21198868407          12/23/2022           1      $382.46       $1.00
        ADM                  132142483001 444980697  MCDONIEL         JESSICA    18   21198868407          12/23/2022           1       $54.86       $1.00
        ADM                  132142483001 444980697  MCDONIEL         JESSICA    18   21198868407          12/23/2022           1       $39.11       $1.00
        ADM                  132142483001 444980697  MCDONIEL         JESSICA    18   21198868407          12/23/2022           1      $250.17       $1.00
        ADM                  134227182001 535689149  HEINSCH          KIMBERLY   18   21398655670          12/30/2022           1       $40.50       $6.18
        ADM                  130351431001 604126359  FERNANDEZ        FRANCISC   18   21398469521          12/27/2022           1      $162.00      $99.68
    ADM Total                                                                                                                       $17,204.79   $7,940.79
    CHAMB
      CHAMB                  105494869001 211600089  HOLLENBAUGH      JAMES      18   21198841424          01/04/2023           1      $376.00     $107.86
      CHAMB                  105494869001 211600089  HOLLENBAUGH      TYLER      19   21198762528          01/03/2023           1      $185.00     $118.97
      CHAMB                  105494869001 211600089  HOLLENBAUGH      TYLER      19   21198762528          01/03/2023           1      $180.00     $173.12

                                                                                                                                              PAGE:18 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      CHAMB                  105494869001 211600089  HOLLENBAUGH      JAMES      18   21198841424          01/04/2023           1       $44.00       $0.00
      CHAMB                  105494869001 211600089  HOLLENBAUGH      TYLER      19   21198762528          01/03/2023           1       $32.00      $21.21
      CHAMB                  105494869001 211600089  HOLLENBAUGH      TYLER      19   21198762528          01/03/2023           1       $25.00      $13.65
      CHAMB                  105494869001 211600089  HOLLENBAUGH      TYLER      19   21198762528          01/03/2023           1       $80.00      $44.58
      CHAMB                  105494869001 211600089  HOLLENBAUGH      TYLER      19   21198762528          01/03/2023           1       $30.00       $0.00
      CHAMB                  105494869001 211600089  HOLLENBAUGH      TYLER      19   21198762528          01/03/2023           2       $64.00      $32.03
      CHAMB                  105494869001 211600089  HOLLENBAUGH      TYLER      19   21198762528          01/03/2023           1       $32.00      $21.21
      CHAMB                  114007147001 215983826  WEIDNER          JAMES      18   21798671561          12/28/2022           1       $49.00      $24.00
      CHAMB                  114007147001 215983826  WEIDNER          JAMES      18   21798671561          12/28/2022           1      $119.00      $22.85
    CHAMB Total                                                                                                                      $1,216.00     $579.48
    CHAR
       CHAR                  135196190001 239139393  GLENN            NEHEMIAH   18   21898645618          12/21/2022           1      $497.00       $3.09
       CHAR                  135196190001 239139393  GLENN            NEHEMIAH   18   21898799876          12/21/2022           1       $43.00       $6.18
       CHAR                  135196190001 239139393  GLENN            NEHEMIAH   18   21898965495          12/21/2022           1       $41.00       $6.18
       CHAR                  135196190001 239139393  GLENN            NEHEMIAH   18   21898645618          12/21/2022           1      $497.00       $3.09
    CHAR Total                                                                                                                       $1,078.00      $18.54
    CHES
       CHES                  127519756001 228089342  STEWART          RICHARD    18   21798847006          12/31/2022           1       $39.00      $23.78
       CHES                  127519756001 228089342  STEWART          RICHARD    18   21798681682          12/27/2022           1      $120.00      $28.22
       CHES                  127519756001 228089342  STEWART          RICHARD    18   21798681682          12/27/2022           1       $39.00      $23.78
       CHES                  127519756001 228089342  STEWART          RICHARD    18   21798847006          12/31/2022           1      $120.00      $28.22
    CHES Total                                                                                                                         $318.00     $104.00
    CKPT2
      CKPT2                  121935242001 179621425  MARTIN           KYRIA      19   21298472482          12/27/2022           1      $167.00      $50.70
      CKPT2                  121935242001 179621425  MARTIN           KYRIA      19   21298472482          12/27/2022           1       $11.00       $4.71
      CKPT2                  121935242001 179621425  MARTIN           KYRIA      19   21298472483          12/27/2022           1      $130.00      $45.42
      CKPT2                  104901321001 204647270  DUTKA            LISA       18   21398485687          12/26/2022           1      $630.00     $178.02
      CKPT2                  104901321001 204647270  DUTKA            LISA       18   21398485687          12/26/2022           1      $437.00      $32.24
      CKPT2                  134499350001 208464299  BLYMIER          JAMES      18   21298053045          09/22/2022          (1)     ($9.65)       $0.00
      CKPT2                  134499350001 208464299  BLYMIER          JAMES      18   21298053045          09/22/2022          (1)    ($46.45)       $0.00
      CKPT2                  134499350001 208464299  BLYMIER          JAMES      18   21298053045          09/22/2022          (1)     ($1.45)       $0.00
      CKPT2                  134499350001 208464299  BLYMIER          JAMES      18   21298053045          09/22/2022          (2)   ($258.94)       $0.00

                                                                                                                                              PAGE:19 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      CKPT2                  134499350001 208464299  BLYMIER          JAMES      18   21298053045          09/22/2022          (3) ($3,336.00)       $0.00
      CKPT2                  134499350001 208464299  BLYMIER          JAMES      18   21298053045          09/22/2022          (1)   ($690.00)       $0.00
      CKPT2                  134499350001 208464299  BLYMIER          JAMES      18   21298053045          09/22/2022          (2)    ($27.80)       $0.00
      CKPT2                  134499350001 208464299  BLYMIER          JAMES      18   21298053045          09/22/2022          (1)    ($46.00)    ($23.21)
      CKPT2                  134499350001 208464299  BLYMIER          JAMES      18   21298053045          09/22/2022          (1)    ($98.00)    ($37.89)
      CKPT2                  134499350001 208464299  BLYMIER          JAMES      18   21298053045          09/22/2022          (1)   ($642.00)       $0.00
      CKPT2                  134499350001 208464299  BLYMIER          JAMES      18   21298053045          09/22/2022          (1)   ($946.00)       $0.00
      CKPT2                  134499350001 208464299  BLYMIER          JAMES      18   21298053045          09/22/2022          (1)    ($72.54)       $0.00
      CKPT2                  134499350001 208464299  BLYMIER          JAMES      18   21298053045          09/22/2022          (1)     ($1.85)       $0.00
      CKPT2                  134499350001 208464299  BLYMIER          JAMES      18   21298053045          09/22/2022         (50)     ($9.25)       $0.00
      CKPT2                  107995714001 433473958  BOYD             MARK       18   21798712629          12/08/2022           1      $115.00       $0.00
    CKPT2 Total                                                                                                                    ($4,695.93)     $249.99
    CLARK
      CLARK                  129151144001 168786798  AGUAS            OLIVIA     18   21198746101          12/31/2022           1       $10.00       $0.00
      CLARK                  129151144001 168786798  AGUAS            OLIVIA     18   21198323451          12/23/2022           1       $56.00       $0.00
      CLARK                  129151144001 168786798  AGUAS            OLIVIA     18   21198323451          12/23/2022           1    $1,529.00   $1,036.50
      CLARK                  129151144001 168786798  AGUAS            OLIVIA     18   21198323451          12/23/2022           1       $49.00       $0.00
      CLARK                  129151144001 168786798  AGUAS            OLIVIA     18   21198406627          12/23/2022           1       $39.00       $8.05
      CLARK                  129151144001 168786798  AGUAS            OLIVIA     18   21198323451          12/23/2022           2      $180.00       $0.00
      CLARK                  129151144001 168786798  AGUAS            OLIVIA     18   21198746101          12/31/2022           1      $122.00      $47.03
      CLARK                  129151144001 168786798  AGUAS            OLIVIA     18   21198746101          12/31/2022           1       $65.00      $25.25
      CLARK                  129151144001 168786798  AGUAS            OLIVIA     18   21198323451          12/23/2022           1       $98.00       $0.00
      CLARK                  129151144001 168786798  AGUAS            OLIVIA     18   21198406589          12/23/2022           1      $484.00     $167.67
      CLARK                  110169138001 172701233  KEENEY           DEREK      19   21398246537          12/23/2022           1      $130.00      $89.99
      CLARK                  110169138001 172701233  KEENEY           ZACHARY    19   21398246538          12/23/2022           1      $130.00      $89.99
      CLARK                  110169138001 172701233  KEENEY           DEREK      19   21398246537          12/23/2022           1      $150.00      $60.04
      CLARK                  110169138001 172701233  KEENEY           DEREK      19   21398246537          12/24/2022           1       $28.00      $11.03
      CLARK                  110169138001 172701233  KEENEY           EMILY      19   21398284514          12/27/2022           1      $150.00      $60.04
      CLARK                  110169138001 172701233  KEENEY           DEREK      19   21398246537          12/24/2022           1       $20.00       $6.30
      CLARK                  110169138001 172701233  KEENEY           ZACHARY    19   21398246538          12/23/2022           1       $45.00      $23.84
      CLARK                  110169138001 172701233  KEENEY           EMILY      19   21398284514          12/27/2022           1      $130.00      $89.99
      CLARK                  110169138001 172701233  KEENEY           CONNOR     19   21398593487          12/30/2022           1       $63.00      $53.48

                                                                                                                                              PAGE:20 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      CLARK                  110169138001 172701233  KEENEY           DEREK      19   21398246537          12/24/2022           1      $130.00      $89.99
      CLARK                  132409588001 192503185  CRISAMORE        ELLIOTT    19   21899041924          12/01/2022          31      $809.10     $186.00
      CLARK                  132409588001 192503185  CRISAMORE        ELLIOTT    19   21899041924          11/01/2022          30      $809.10     $180.00
      CLARK                  132409588001 192503185  CRISAMORE        ELLIOTT    19   21498673360          12/27/2022           1       $76.00      $42.09
      CLARK                  132409588001 192503185  CRISAMORE        ELLIOTT    19   21498673330          12/26/2022           1      $385.50     $209.59
      CLARK                  132409588001 192503185  CRISAMORE        ELLIOTT    19   21498528115          12/26/2022           1       $19.00      $10.04
      CLARK                  132409588001 192503185  CRISAMORE        ELLIOTT    19   21899041924          11/29/2022           1      $150.00      $31.08
      CLARK                  132409588001 192503185  CRISAMORE        ELLIOTT    19   21498876866          12/27/2022           1      $212.00      $97.94
      CLARK                  132409588001 192503185  CRISAMORE        ELLIOTT    19   21498673182          12/26/2022           1      $401.00     $184.60
      CLARK                  132409588001 192503185  CRISAMORE        AUDREY     01   21498673245          12/29/2022           1      $133.00      $50.70
      CLARK                  132409588001 192503185  CRISAMORE        ELLIOTT    19   21498528115          12/26/2022           1      $171.00      $93.39
      CLARK                  132409588001 192503185  CRISAMORE        ELLIOTT    19   21498528114          12/26/2022           1      $124.00      $59.80
    CLARK Total                                                                                                                      $6,897.70   $3,004.42
    COLUM
      COLUM                  119309736001 287502600  KIRWIN           THOMAS     18   21397477004          07/22/2022           1       $45.00       $3.09
      COLUM                  119309736001 287502600  KIRWIN           THOMAS     18   21398572613          11/30/2022           1       $50.00       $6.18
      COLUM                  119309736001 287502600  KIRWIN           THOMAS     18   21387946315          07/22/2022          (1)    ($45.00)     ($3.09)
      COLUM                  119309736001 287502600  KIRWIN           THOMAS     18   21397477004          07/22/2022           1        $5.00       $3.09
      COLUM                  119309736001 287502600  KIRWIN           THOMAS     18   21387946315          07/22/2022          (1)     ($5.00)     ($3.09)
      COLUM                  132095042001 299821636  PARKS            MICHELLE   01   21898965924          12/21/2022           1      $138.00      $14.49
      COLUM                  132095042001 299821636  PARKS            MICHELLE   01   21885425159          05/24/2022           1      $262.00      $83.19
      COLUM                  132095042001 299821636  PARKS            MICHELLE   01   21884792574          05/24/2022           1    $3,496.40   $2,193.38
    COLUM Total                                                                                                                      $3,946.40   $2,297.24
    DENV
       DENV                  104634536001 201582444  PRITCHARD        CARL       18   21598724637          12/30/2022           2      $106.00      $36.35
       DENV                  104634536001 201582444  PRITCHARD        CARL       18   21598724637          12/30/2022           2      $110.00      $37.65
       DENV                  127520277001 523088824  MOORE            CAROL      18   21699300317          12/09/2022           1      $530.00     $146.31
    DENV Total                                                                                                                         $746.00     $220.31
    FESPLT
      FESPLT                 133287953001 362022828  VANDEN BERGE     SUSAN      01   21597524406          12/07/2022           1      $380.00     $207.81
      FESPLT                 133287953001 362022828  VANDEN BERGE     SUSAN      01   21597524406          12/07/2022           1       $75.00      $51.47
      FESPLT                 132884809001 373351965  DIAZ-MARTINEZ    FLORENTI   18   21798854109          12/27/2022           1       $86.00       $1.95

                                                                                                                                              PAGE:21 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      FESPLT                 132884809001 373351965  DIAZ-MARTINEZ    FLORENTI   18   21798854109          12/27/2022           1       $24.00       $1.99
      FESPLT                 132938863001 375047084  MCMURRAY         BRAYDEN    19   21798604088          12/20/2022           1      $392.00     $170.83
      FESPLT                 132900470001 378823964  NARDIN           DOUGLAS    18   21899240979          12/28/2022           1      $105.00      $68.33
      FESPLT                 132900470001 378823964  NARDIN           DOUGLAS    18   21899240979          12/28/2022           1       $24.00       $2.00
      FESPLT                 132938869001 597484965  TORRES SERRANO   MIKAELA    19   21498892219          12/30/2022           1      $168.00      $25.78
    FESPLT Total                                                                                                                     $1,254.00     $530.16
    FLEET
      FLEET                  102869483001 180505253  FOWLER           STEVEN     18   21597942651          12/05/2022           1      $530.00     $139.61
    FLEET Total                                                                                                                        $530.00     $139.61
    FORPK
      FORPK                  106468594001 259943181  SHERIDAN         GLYNN      18   21798848177          12/19/2022           2      $100.00      $55.56
      FORPK                  106468594001 259943181  SHERIDAN         GLYNN      18   21797755259          12/05/2022           1      $542.00     $133.09
      FORPK                  106468594001 259943181  SHERIDAN         GLYNN      18   21798848177          12/19/2022           1      $155.00      $93.44
      FORPK                  106468594001 259943181  SHERIDAN         GLYNN      18   21798848177          12/27/2022           2      $110.00      $69.87
      FORPK                  106468594001 259943181  SHERIDAN         GLYNN      18   21798848177          12/27/2022           2      $100.00      $55.57
      FORPK                  106468594001 259943181  SHERIDAN         GLYNN      18   21797755259          12/05/2022           1      $597.00     $145.09
      FORPK                  133920061001 439211322  LASALLE          TONNISHA   01   21798845386          12/08/2022           1      $270.00     $154.57
      FORPK                  133920061001 439211322  LASALLE          GREGORY    18   21798437488          12/11/2022           1      $137.00     $143.18
      FORPK                  133920061001 439211322  LASALLE          GREGORY    18   21799123224          12/29/2022           1       $58.00       $3.09
      FORPK                  133920061001 439211322  LASALLE          GREGORY    18   21799123224          12/29/2022           1      $270.00     $151.48
    FORPK Total                                                                                                                      $2,339.00   $1,004.94
    FRAZ
       FRAZ                  128991032001 195687564  DORTON           HEATHER    18   21898997219          12/29/2022           2      $226.82       $0.00
       FRAZ                  128991032001 195687564  DORTON           HEATHER    18   21898997219          12/29/2022           1      $228.52       $0.00
       FRAZ                  128991032001 195687564  DORTON           HEATHER    18   21898818718          12/27/2022           1      $181.00       $0.00
       FRAZ                  128991032001 195687564  DORTON           HEATHER    18   21898818717          12/27/2022           1      $112.33       $0.00
       FRAZ                  128991032001 195687564  DORTON           HEATHER    18   21899143180          12/29/2022           1      $225.00     $101.05
       FRAZ                  128991032001 195687564  DORTON           HEATHER    18   21898997219          12/29/2022           1      $113.41      $33.50
       FRAZ                  128991032001 195687564  DORTON           HEATHER    18   21898818718          12/27/2022           1       $98.00      $13.00
       FRAZ                  128991032001 195687564  DORTON           HEATHER    18   21898997219          12/29/2022           1      $113.41      $33.50
       FRAZ                  128991032001 195687564  DORTON           HEATHER    18   21898997219          12/29/2022           1      $113.41       $0.00
       FRAZ                  128991032001 195687564  DORTON           HEATHER    18   21899087896          12/29/2022           1      $154.94      $36.28

                                                                                                                                              PAGE:22 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       FRAZ                  128991032001 195687564  DORTON           HEATHER    18   21898818718          12/27/2022           1       $31.00       $0.00
       FRAZ                  128991032001 195687564  DORTON           HEATHER    18   21899087896          12/29/2022           1      $143.06      $33.50
       FRAZ                  128991032001 195687564  DORTON           HEATHER    18   21898997219          12/29/2022           1      $113.43       $0.00
       FRAZ                  128991032001 195687564  DORTON           HEATHER    18   21898818717          12/27/2022           1      $182.34       $0.00
       FRAZ                  128991032001 195687564  DORTON           HEATHER    18   21898818717          12/27/2022           1      $115.33       $0.00
    FRAZ Total                                                                                                                       $2,152.00     $250.83
    FREE
       FREE                  132990694001 148725616  KASZUBA          STEPHEN    18   21798954327          12/26/2022           1      $310.00     $194.02
    FREE Total                                                                                                                         $310.00     $194.02
    GFADM
      GFADM                  135144200001 415962237  WEBB             ERIC       18   21298593371          12/21/2022           1       $70.00       $1.24
      GFADM                  135144200001 415962237  WEBB             ERIC       18   21298593371          12/21/2022           1       $77.00       $1.24
      GFADM                  135144200001 415962237  WEBB             ERIC       18   21298593371          12/21/2022           1       $86.00       $1.23
      GFADM                  135144200001 415962237  WEBB             ERIC       18   21298593371          12/21/2022           1      $315.00       $1.24
      GFADM                  135144200001 415962237  WEBB             ERIC       18   21298593371          12/21/2022           1      $125.00       $1.23
    GFADM Total                                                                                                                        $673.00       $6.18
    GFPLT
      GFPLT                  122212623001 416904228  PINKARD          LOUIS      18   21398485898          12/14/2022           1       $56.00       $3.09
      GFPLT                  122212623001 416904228  PINKARD          LOUIS      18   21398485898          12/14/2022           1       $52.00       $3.09
      GFPLT                  124027904001 417292042  SMITH            EMMALEE    19   21298573037          12/16/2022           1      $374.00      $77.02
      GFPLT                  124027904001 417292042  SMITH            EMMALEE    19   21298573037          12/16/2022           1      $167.00       $8.21
      GFPLT                  124027904001 417292042  SMITH            EMMALEE    19   21298330271          02/02/2022           1    $1,475.00     $541.48
      GFPLT                  124027904001 417292042  SMITH            EMMALEE    19   21297876361          12/16/2022           1    $2,748.00     $835.55
      GFPLT                  124027904001 417292042  SMITH            EMMALEE    19   21298573037          12/16/2022           1      $232.00      $16.03
      GFPLT                  124027904001 417292042  SMITH            EMMALEE    19   21298573037          12/16/2022           1      $323.00       $6.36
      GFPLT                  124027904001 417292042  SMITH            EMMALEE    19   21298573037          12/16/2022           1      $241.00       $8.20
      GFPLT                  124027904001 417292042  SMITH            EMMALEE    19   21297876361          12/16/2022           1    $2,934.00     $350.80
      GFPLT                  124027904001 417292042  SMITH            EMMALEE    19   21298330271          02/02/2022           1      $225.00     $145.72
      GFPLT                  124027904001 417292042  SMITH            EMMALEE    19   21298573037          12/16/2022           1      $232.00      $16.03
      GFPLT                  124027904001 417292042  SMITH            EMMALEE    19   21298573037          12/16/2022           1      $216.00       $3.76
      GFPLT                  112786039001 417842678  LOONEY           MYRON      18   21198870484          12/18/2022           1      $200.00       $3.09
      GFPLT                  112786039001 417842678  LOONEY           MYRON      18   21198870484          12/18/2022           1      $111.00       $3.09

                                                                                                                                              PAGE:23 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      GFPLT                  121950237001 418943984  JONES            SEARCY     18   21398653434          12/28/2022           1      $246.00      $85.18
      GFPLT                  130858747001 419060646  MATT             CHRISTOP   18   21799123304          01/03/2023           1      $266.00      $79.99
      GFPLT                  132900477001 420395562  INGRAM           AARON      18   21698872030          12/01/2022           1      $100.00      $31.63
      GFPLT                  132900477001 420395562  INGRAM           AARON      18   21698872030          12/01/2022           4        $8.00       $0.62
      GFPLT                  132900477001 420395562  INGRAM           AARON      18   21698872030          12/01/2022           1       $80.00       $0.62
      GFPLT                  132900477001 420395562  INGRAM           AARON      18   21698872030          12/01/2022           1       $30.00       $8.56
      GFPLT                  132900477001 420395562  INGRAM           AARON      18   21698872030          12/01/2022           1      $170.00      $95.61
      GFPLT                  132900477001 420395562  INGRAM           AARON      18   21698872030          12/01/2022           1       $28.00       $0.62
      GFPLT                  132900477001 420395562  INGRAM           AARON      18   21698872030          12/01/2022           1       $34.00      $11.74
      GFPLT                  132900477001 420395562  INGRAM           AARON      18   21698872030          12/01/2022           1       $37.00       $0.62
      GFPLT                  132900477001 420395562  INGRAM           AARON      18   21699117529          12/28/2022           1      $110.00       $6.18
      GFPLT                  132900477001 420395562  INGRAM           AARON      18   21698872030          12/01/2022           1       $15.00       $0.62
      GFPLT                  132900477001 420395562  INGRAM           AARON      18   21698872030          12/01/2022           1       $34.00      $11.74
      GFPLT                  114833360001 422949079  DUNN             DONNETTA   18   21298762015          12/14/2022           1      $140.00      $94.99
      GFPLT                  107824315001 422960552  LEONARD          EDDIE      18   21498891797          12/27/2022           1      $264.00      $10.96
      GFPLT                  107836195001 423867346  JOHNSON WATSON   LUCINDA    01   21498710054          12/28/2022           4      $184.88      $13.78
    GFPLT Total                                                                                                                     $11,332.88   $2,474.98
    HAN4
       HAN4                  127519626001 215864525  KELLY            VIVIAN     19   21398640553          01/02/2023           1      $119.00      $50.70
       HAN4                  127519626001 215864525  KELLY            VIVIAN     19   21398640553          01/02/2023           1       $73.00       $0.00
       HAN4                  127519626001 215864525  KELLY            VIVIAN     19   21398640553          01/02/2023           1       $49.00       $0.00
    HAN4 Total                                                                                                                         $241.00      $50.70
    INRDC
      INRDC                  130658132001 316177855  BRICKLEY         KORYN      18   21298571645          12/26/2022           1      $150.00      $24.61
      INRDC                  130658132001 316177855  BRICKLEY         KORYN      18   21298846129          01/04/2023           1      $160.00       $6.18
      INRDC                  130658132001 316177855  BRICKLEY         KORYN      18   21298571645          12/26/2022           1       $32.00       $9.65
    INRDC Total                                                                                                                        $342.00      $40.44
    INVAZ
      INVAZ                  127930898001 527933346  RUELAS           MARTIN     19   21298579563          12/13/2022           1      $371.00      $10.24
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21798960756          11/22/2022           1    $2,160.00     $653.67
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21798960756          11/22/2022           1      $303.00      $39.08
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21798865432          09/27/2022           1      $221.00      $96.87

                                                                                                                                              PAGE:24 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21796876283          11/22/2022          (1)   ($228.00)    ($29.38)
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21796876283          11/22/2022          (1)   ($303.00)    ($39.25)
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21792724768          09/27/2022          (1)   ($221.00)    ($95.14)
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21796876283          11/22/2022          (1)     ($9.00)    ($10.39)
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21798960756          11/22/2022           1      $153.00      $13.91
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21798960756          11/22/2022           1      $228.00      $29.21
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21798844756          12/21/2022           1      $180.00     $109.36
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21798844756          12/21/2022          60    $3,075.00     ($0.01)
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21796876283          11/22/2022          (1) ($2,160.00)   ($653.85)
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21792724768          09/27/2022          (1)    ($92.00)    ($41.96)
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21798960756          11/22/2022           1        $9.00      $10.21
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21798865432          09/27/2022           1       $92.00      $42.71
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21796876283          11/22/2022          (1)   ($178.00)    ($39.65)
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21796876283          11/22/2022          (1) ($3,156.00)   ($574.15)
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21798960756          11/22/2022           1      $178.00      $39.48
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21796876283          11/22/2022          (1)   ($153.00)    ($14.08)
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21798960756          11/22/2022           1    $3,156.00     $573.97
      INVAZ                  127920427001 551750843  CERVANTES        VICTOR     18   21798960756          11/22/2022           1       $63.00       $2.55
      INVAZ                  127930905001 600203917  GRADO            MIA        19   22016750564          12/01/2022           1       $50.00      $14.83
      INVAZ                  127937161001 601089470  LUTZ             NICHOLAS   18   21198599222          11/30/2022           1    $2,025.00     $427.25
      INVAZ                  134397594001 601964765  AVITIA           JOHANNA    18   22017677530          12/05/2022           1      $325.00      $95.42
      INVAZ                  127912552001 608198286  DIAZ             MARIA      18   21798955173          12/29/2022           2      $158.00      $22.22
      INVAZ                  127912552001 608198286  DIAZ             MARIA      18   21798955173          12/29/2022           1      $890.00     $270.55
      INVAZ                  127912552001 608198286  DIAZ             MARIA      18   21798955173          12/29/2022           1       $16.00       $0.85
      INVAZ                  127912552001 608198286  DIAZ             MARIA      18   21798955173          12/29/2022           1      $301.00      $53.35
      INVAZ                  127912552001 608198286  DIAZ             MARIA      18   21798845749          12/28/2022           1      $318.98      $56.24
      INVAZ                  127912552001 608198286  DIAZ             MARIA      18   21798955173          12/29/2022           1      $130.00      $18.47
      INVAZ                  127912552001 608198286  DIAZ             MARIA      18   21798955173          12/29/2022           1       $37.00       $4.08
      INVAZ                  127912552001 608198286  DIAZ             MARIA      18   21798955173          12/29/2022           1       $73.00      $11.46
      INVAZ                  127912552001 608198286  DIAZ             MARIA      18   21798955173          12/29/2022           1       $88.00      $12.03
      INVAZ                  127937165001 610480667  MARTINEZ         SANTOS     18   21598725186          12/29/2022           1       $10.00       $3.92
      INVAZ                  127937165001 610480667  MARTINEZ         SANTOS     18   21598725186          12/29/2022           1      $137.00      $21.94

                                                                                                                                              PAGE:25 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      INVAZ                  127937165001 610480667  MARTINEZ         SANTOS     18   21598617417          11/29/2022           1      $394.00     $174.68
      INVAZ                  130630709001 619542889  GASTELUM         JAIME      18   21298410511          12/27/2022           1      $268.00      $48.12
      INVAZ                  132711083001 625134116  CABALLERO        FLORINA    18   21898968587          12/01/2022           1       $92.00       $3.36
      INVAZ                  132711083001 625134116  CABALLERO        FLORINA    18   21898968587          12/01/2022           1       $93.00       $3.22
      INVAZ                  129848126001 731266038  ARZABA           FRANCISC   01   21598204921          08/22/2022           1       $28.99      $26.46
      INVAZ                  129848126001 731266038  ARZABA           FRANCISC   01   21598637666          12/30/2022           1      $120.00      $12.28
      INVAZ                  127930920001 765066757  PORTILLO         BENIGNO    18   21699116174          12/15/2022           1      $180.00      $86.09
      INVAZ                  127930920001 765066757  PORTILLO         BENIGNO    18   21699116174          12/15/2022           1        $1.00       $1.01
      INVAZ                  127930920001 765066757  PORTILLO         BENIGNO    18   21699116174          12/15/2022           1        $1.00       $1.02
      INVAZ                  127930920001 765066757  PORTILLO         BENIGNO    18   21699116174          12/15/2022           1        $1.00       $1.02
    INVAZ Total                                                                                                                      $9,426.97   $1,493.27
    INVIN
      INVIN                  129586960001 303504176  WAGGONER         TRACI      18   21198593868          12/16/2022           1      $405.00     $206.18
      INVIN                  129586960001 303504176  WAGGONER         RICKY      01   21190322163          07/18/2022          (1)    ($97.00)    ($36.82)
      INVIN                  129586960001 303504176  WAGGONER         RICKY      01   21189338752          07/18/2022          (1)    ($97.00)    ($36.82)
      INVIN                  127920396001 305788052  HUDGINS          LAURA      18   21398469558          12/22/2022           2       $96.00      $41.59
      INVIN                  127920396001 305788052  HUDGINS          LAURA      18   21398467296          12/29/2022           2       $96.00      $41.52
      INVIN                  127920396001 305788052  HUDGINS          LAURA      18   21398469558          12/22/2022           4      $192.00      $79.95
      INVIN                  127920396001 305788052  HUDGINS          LAURA      18   21398467750          12/19/2022           2       $96.00      $41.59
      INVIN                  127920396001 305788052  HUDGINS          LAURA      18   21398467296          12/29/2022           2       $96.00      $41.59
      INVIN                  127920396001 305788052  HUDGINS          LAURA      18   21398467750          12/19/2022           3      $144.00      $60.74
      INVIN                  127920399001 306889778  REYNOLDS         TRACY      18   21688685822          07/25/2022          (1)   ($139.00)    ($19.63)
      INVIN                  135300727001 313764168  HERBER           JACQUELI   18   21198594393          12/07/2022           1      $110.00      $59.57
      INVIN                  127920417001 316925878  HOLMES           ARIYAH     19   21698699069          12/19/2022           1       $45.00      $16.64
      INVIN                  127920417001 316925878  HOLMES           ARIYAH     19   21698703593          12/19/2022           1      $833.15     $246.19
      INVIN                  127920417001 316925878  HOLMES           ARIYAH     19   21698703593          12/19/2022           1      $240.40      $71.91
      INVIN                  127920417001 316925878  HOLMES           ARIYAH     19   21698703593          12/19/2022           1      $162.85      $49.12
      INVIN                  127920417001 316925878  HOLMES           ARIYAH     19   21698703593          12/19/2022           1       $95.50      $29.32
      INVIN                  127920417001 316925878  HOLMES           ARIYAH     19   21698703593          12/19/2022           1       $74.55      $23.15
      INVIN                  134685341001 316944723  COLLINS          ADRIANNA   19   21898959463          12/28/2022           1       $45.00       $3.09
      INVIN                  134685341001 316944723  COLLINS          ASHTON     19   21898966885          12/20/2022           1      $125.00       $6.18
      INVIN                  134685341001 316944723  COLLINS          ADRIANNA   19   21898959463          12/28/2022           1       $35.00       $3.09

                                                                                                                                              PAGE:26 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      INVIN                  134685341001 316944723  COLLINS          ADRIANNA   19   21899149952          12/22/2022           1      $150.00       $6.18
      INVIN                  127920420001 317601973  CALVERT          GEORGE     18   22017677766          12/28/2022           4      $400.00     $102.26
      INVIN                  127920420001 317601973  CALVERT          GEORGE     18   22017791973          12/30/2022           4      $400.00     $102.26
      INVIN                  127930884001 317763433  GINTER           NONDIS     18   21699388658          12/30/2022           1       $78.75       $2.06
      INVIN                  127930884001 317763433  GINTER           NONDIS     18   21699388658          12/30/2022           1      $179.55       $2.06
      INVIN                  127930884001 317763433  GINTER           NONDIS     18   21699304660          12/19/2022           1      $244.00     $117.70
      INVIN                  127930884001 317763433  GINTER           NONDIS     18   21699388658          12/30/2022           1      $102.90       $2.06
    INVIN Total                                                                                                                      $4,113.65   $1,262.73
    JACKS
      JACKS                  129624176001 590532797  SCHIFFBAUER      CHELSEA    01   21298849537          12/28/2022           1    $1,596.00     $497.38
      JACKS                  129624176001 590532797  SCHIFFBAUER      CHELSEA    01   21298575292          12/14/2022           1        $6.82       $3.08
      JACKS                  129624176001 590532797  SCHIFFBAUER      CHELSEA    01   21298575292          12/14/2022           1       $44.99       $3.69
      JACKS                  129624176001 590532797  SCHIFFBAUER      CHELSEA    01   21298575292          12/14/2022           1       $45.00       $3.69
      JACKS                  129624176001 590532797  SCHIFFBAUER      CHELSEA    01   21298575292          12/14/2022           1        $8.66       $3.72
      JACKS                  129624176001 590532797  SCHIFFBAUER      CHELSEA    01   21298575292          12/14/2022           1       $52.87       $4.51
      JACKS                  129624176001 590532797  SCHIFFBAUER      CHELSEA    01   21298849537          12/28/2022           1       $12.00       $4.27
      JACKS                  129624176001 590532797  SCHIFFBAUER      CHELSEA    01   21298849537          12/28/2022           1      $856.00     $273.13
      JACKS                  129624176001 590532797  SCHIFFBAUER      CHELSEA    01   21298849537          12/28/2022           1      $869.00     $194.29
      JACKS                  129624176001 590532797  SCHIFFBAUER      CHELSEA    01   21298575292          12/14/2022           1       $49.00       $4.94
      JACKS                  129624176001 590532797  SCHIFFBAUER      CHELSEA    01   21298575292          12/14/2022           1      $119.24      $13.34
      JACKS                  129624176001 590532797  SCHIFFBAUER      CHELSEA    01   21298575292          12/14/2022           1        $6.82       $3.09
    JACKS Total                                                                                                                      $3,666.40   $1,009.13
    KCSLS
      KCSLS                  130539767001 342727462  WILSON           KELLY      01   21598536664          12/29/2022           1       $40.00       $5.00
      KCSLS                  130539776001 349708883  DONALDSON        NICHOLE    01   21598619888          12/26/2022           1      $213.47     $217.47
      KCSLS                  130539776001 349708883  DONALDSON        NICHOLE    01   21598899921          12/26/2022           1       $19.70      $13.07
      KCSLS                  130539776001 349708883  DONALDSON        NICHOLE    01   21598899921          12/26/2022           1      $150.00      $63.01
      KCSLS                  130539776001 349708883  DONALDSON        NICHOLE    01   21598899921          12/26/2022           1      $116.67      $49.74
      KCSLS                  130539779001 352545378  SINNETT          SUZANNA    18   21899160116          11/03/2022           1      $191.00      $63.21
      KCSLS                  130539779001 352545378  SINNETT          SUZANNA    18   21899160116          11/03/2022           1      $212.00       $2.00
      KCSLS                  130539779001 352545378  SINNETT          SUZANNA    18   21899238127          12/16/2022           1      $192.00      $53.79
      KCSLS                  130539779001 352545378  SINNETT          SUZANNA    18   21895322011          11/03/2022          (1)   ($191.00)     ($4.00)

                                                                                                                                              PAGE:27 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      KCSLS                  130539780001 353867113  RADER            BRYAN      18   22017981568          12/02/2022           3      $594.00     $246.41
    KCSLS Total                                                                                                                      $1,537.84     $709.70
    KMPLT
      KMPLT                  134673768001 241316606  ATKINSON         WILLIAM    18   22017503044          11/29/2022           1       $75.00       $3.09
      KMPLT                  134673768001 241316606  ATKINSON         WILLIAM    18   22017503044          11/29/2022           1       $32.00       $3.09
    KMPLT Total                                                                                                                        $107.00       $6.18
    LAUR
       LAUR                  106354090001 252319913  WATTS            MELISSA    01   21198870287          01/01/2023           1       $49.00       $4.00
       LAUR                  106354090001 252319913  WATTS            MELISSA    01   21198598763          12/11/2022           1      $639.00     $232.80
       LAUR                  106354090001 252319913  WATTS            MELISSA    01   21198597889          12/12/2022           1      $143.00      $60.63
       LAUR                  106354090001 252319913  WATTS            MELISSA    01   21198598335          12/14/2022           1      $212.00      $86.25
       LAUR                  106354090001 252319913  WATTS            MELISSA    01   21198280045          12/10/2022           1      $850.00     $682.00
       LAUR                  106354090001 252319913  WATTS            MELISSA    01   21198870179          12/29/2022           1      $257.00      $61.19
       LAUR                  106354090001 252319913  WATTS            MELISSA    01   21198280045          12/10/2022          13      $302.40     $243.92
       LAUR                  106354090001 252319913  WATTS            MELISSA    01   21198598335          12/13/2022           1      $143.00      $58.63
       LAUR                  106354090001 252319913  WATTS            MELISSA    01   21198870180          12/30/2022           1      $257.00      $61.19
       LAUR                  106354090001 252319913  WATTS            MELISSA    01   21198869446          12/21/2022           1    $1,163.00     $231.63
       LAUR                  106354090001 252319913  WATTS            MELISSA    01   21198701751          12/29/2022           1      $260.00     $153.71
    LAUR Total                                                                                                                       $4,275.40   $1,875.95
    MANAS
      MANAS                  127519783001 230847388  O'CONNOR         ELIZABET   01   21799127313          01/03/2023           1      $192.72      $47.71
    MANAS Total                                                                                                                        $192.72      $47.71
    MKTG
       MKTG                  127519219001 164463960  WEIKERT          SCOTT      18   21198664180          12/29/2022           1       $25.00       $0.00
       MKTG                  127519219001 164463960  WEIKERT          SCOTT      18   21198420290          12/13/2022           1      $523.00     $249.89
       MKTG                  127519219001 164463960  WEIKERT          SCOTT      18   21198676586          12/29/2022           1      $244.75     $144.32
       MKTG                  127519219001 164463960  WEIKERT          SCOTT      18   21198502553          12/29/2022           1       $38.00      $12.68
       MKTG                  127519219001 164463960  WEIKERT          SCOTT      18   21198664180          12/30/2022           1      $370.00       $0.00
       MKTG                  127519219001 164463960  WEIKERT          SCOTT      18   21198664180          12/29/2022           1    $1,489.00   $1,320.60
       MKTG                  127519219001 164463960  WEIKERT          SCOTT      18   21198664180          12/30/2022           1       $29.00       $0.00
       MKTG                  127519412001 187626415  ROBERTS          JEFFREY    18   21598580309          12/23/2022           1      $262.00       $0.00
       MKTG                  127519412001 187626415  ROBERTS          JEFFREY    18   21598580309          12/23/2022           1      $262.00       $0.00

                                                                                                                                              PAGE:28 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       MKTG                  132228406001 633341775  BULLA            NOVA       19   21198430154          12/11/2022           1      $984.00     $400.38
       MKTG                  132228406001 633341775  BULLA            NOVA       19   21198867136          12/12/2022           1    $1,566.00     $466.72
    MKTG Total                                                                                                                       $5,792.75   $2,594.59
    MOBL
       MOBL                  127519919001 261886050  BRAYER           CRAIG      18   21898968529          12/29/2022           1      $108.00      $18.93
    MOBL Total                                                                                                                         $108.00      $18.93
    NEW
        NEW                  127519134001 097589598  ATTANASIO        RICHARD    18   21699131811          11/16/2022           1      $138.00      $16.87
        NEW                  127519134001 097589598  ATTANASIO        RICHARD    18   21699131811          11/16/2022           1      $107.17      $54.48
        NEW                  134373698001 130686310  FALCON           PARKER     19   21899238434          11/04/2022           1      $142.00      $38.11
    NEW Total                                                                                                                          $387.17     $109.46
    OHRDC
      OHRDC                  133740436001 294965208  MITTAS           ARIS       18   21498451601          12/28/2022           1       $40.00      $40.00
    OHRDC Total                                                                                                                         $40.00      $40.00
    PLT1
       PLT1                  127519522001 203684453  BOYERS           ARCHIE     19   21798945101          01/02/2023           1      $195.00     $183.57
       PLT1                  127519522001 203684453  BOYERS           ARCHIE     19   21798945101          01/02/2023           1      $130.00     $107.03
       PLT1                  127519522001 203684453  BOYERS           ARCHIE     19   21798945101          01/02/2023           1      $285.00     $285.00
       PLT1                  127519522001 203684453  BOYERS           ARCHIE     19   21798945101          01/02/2023           4      $156.00      $80.80
       PLT1                  127519522001 203684453  BOYERS           ARCHIE     19   21798945101          01/02/2023           5      $125.00      $76.25
       PLT1                  127519522001 203684453  BOYERS           ARCHIE     19   21798945101          01/02/2023           1       $38.00      $24.36
       PLT1                  127519522001 203684453  BOYERS           ARCHIE     19   21798945101          01/02/2023           1       $10.00       $2.69
       PLT1                  127519522001 203684453  BOYERS           ARCHIE     19   21798945101          01/02/2023           1      $130.00     $119.30
    PLT1 Total                                                                                                                       $1,069.00     $879.00
    PLT18
      PLT18                  122065201001 255513178  FAUGHT           DAVID      18   21198702775          12/21/2022           1       $43.00      $29.61
      PLT18                  122065201001 255513178  FAUGHT           DAVID      18   21198702775          12/21/2022           1      $136.50       $1.23
      PLT18                  122065201001 255513178  FAUGHT           DAVID      18   21198702775          12/21/2022           1       $27.00      $20.35
      PLT18                  122065201001 255513178  FAUGHT           DAVID      18   21198702775          12/21/2022           1      $150.00      $52.54
      PLT18                  122065201001 255513178  FAUGHT           DAVID      18   21198702775          12/21/2022           1       $50.00      $24.70
      PLT18                  110784706001 419921072  MORTON           DEBRA      01   21798425649          12/21/2022           1      $154.00     $118.68
      PLT18                  110784706001 419921072  MORTON           DEBRA      01   21798425649          12/21/2022           1       $33.00      $11.89

                                                                                                                                              PAGE:29 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      PLT18                  110784706001 419921072  MORTON           DEBRA      01   21798425649          12/21/2022           1       $35.00      $25.77
      PLT18                  110784706001 419921072  MORTON           DEBRA      01   21798425649          12/21/2022          20       $20.00       $0.78
      PLT18                  110784706001 419921072  MORTON           DEBRA      01   21798425649          12/21/2022           1       $33.00      $11.89
      PLT18                  110784706001 419921072  MORTON           DEBRA      01   21798425649          12/21/2022           4       $20.00       $0.78
      PLT18                  110784706001 419921072  MORTON           DEBRA      01   21798425649          12/21/2022           1       $44.00       $0.77
      PLT18                  110784706001 419921072  MORTON           DEBRA      01   21798425649          12/21/2022           1       $39.00      $13.46
      PLT18                  121950521001 421134367  PRICE            JOSHUA     19   21899235306          12/20/2022           1       $43.00      $33.18
      PLT18                  121950521001 421134367  PRICE            JOSHUA     19   21899241016          12/24/2022           1       $40.00      $28.80
      PLT18                  121950521001 421134367  PRICE            JOSHUA     19   21899237672          12/26/2022           1       $40.00      $28.80
      PLT18                  107833107001 423665791  POWELL           SIDNEY     01   21398743843          12/05/2022           1      $149.00     $150.54
      PLT18                  107833107001 423665791  POWELL           SIDNEY     01   21398466586          12/08/2022           1      $170.00      $95.77
      PLT18                  107833107001 423665791  POWELL           SIDNEY     01   21398743843          12/05/2022           1      $131.00      $71.49
      PLT18                  107833107001 423665791  POWELL           SIDNEY     01   21398466586          12/08/2022           1       $30.00       $8.72
      PLT18                  107833107001 423665791  POWELL           SIDNEY     01   21398743843          12/05/2022           1       $19.79      $21.33
      PLT18                  107833107001 423665791  POWELL           SIDNEY     01   21398466586          12/08/2022           1       $38.00      $11.89
      PLT18                  107833107001 423665791  POWELL           SIDNEY     01   21398466586          12/08/2022           1       $37.00      $11.55
      PLT18                  107833107001 423665791  POWELL           SIDNEY     01   21398466586          12/08/2022           1       $70.00      $51.77
      PLT18                  107833107001 423665791  POWELL           SIDNEY     01   21398743843          12/05/2022           1       $46.00      $24.89
      PLT18                  107833107001 423665791  POWELL           SIDNEY     01   21398466586          12/08/2022           1       $34.00      $11.90
      PLT18                  107833107001 423665791  POWELL           SIDNEY     01   21398466586          12/08/2022           1      $100.00      $31.79
      PLT18                  107833107001 423665791  POWELL           SIDNEY     01   21398466586          12/08/2022           1       $34.00      $11.89
    PLT18 Total                                                                                                                      $1,766.29     $906.76
    PLT2
       PLT2                  127519163001 142153055  MORA-REINOSO     MINERVA    01   21898526705          12/22/2022           1       $10.00       $0.00
       PLT2                  127519163001 142153055  MORA-REINOSO     MINERVA    01   21898526705          12/22/2022           1      $121.00       $0.00
       PLT2                  127519163001 142153055  MORA-REINOSO     MINERVA    01   21898772037          12/27/2022           1      $380.00       $0.00
       PLT2                  101499891001 163442294  STOCKHAM         KAYLA      19   21699118834          12/21/2022           1      $249.45      $51.84
       PLT2                  133919968001 167826484  PEREZ            MERCED     18   21498876904          12/30/2022           2       $50.00      $30.50
       PLT2                  133919968001 167826484  PEREZ            MERCED     18   21498876904          12/30/2022           1      $154.00     $154.00
       PLT2                  133919968001 167826484  PEREZ            MERCED     18   21498876904          12/30/2022           1       $40.00      $20.20
       PLT2                  133919968001 167826484  PEREZ            MERCED     18   21498876904          12/30/2022           1      $282.00     $118.88
       PLT2                  133919968001 167826484  PEREZ            MERCED     18   21498876904          12/30/2022           1       $40.00      $24.36

                                                                                                                                              PAGE:30 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT2                  127519261001 170540907  WOLFE            ALLAN      01   21798752802          12/28/2022           1       $24.00      $12.36
       PLT2                  127519261001 170540907  WOLFE            ALLAN      01   21798628888          12/08/2022           1      $170.00      $85.70
       PLT2                  127519261001 170540907  WOLFE            ALLAN      01   21798628884          07/11/2022           1    $3,394.00     $235.65
       PLT2                  127519261001 170540907  WOLFE            ALLAN      01   21798628885          07/22/2022           1      $822.00     $109.51
       PLT2                  127519261001 170540907  WOLFE            ALLAN      01   21798628887          12/08/2022           1      $449.00      $61.42
       PLT2                  127519261001 170540907  WOLFE            ALLAN      01   21799022621          01/03/2023           1      $277.00     $107.86
       PLT2                  127519261001 170540907  WOLFE            ALLAN      01   21798628886          11/10/2022           1      $822.00     $109.51
       PLT2                  134967804001 172826486  AGUILAR-DUARTE   ADAN       18   21699154285          12/21/2022           1      $120.00       $0.00
       PLT2                  131594120001 174760177  WETZEL           KRISTINA   18   21899122553          01/03/2023           1      $178.00      $50.70
       PLT2                  116931972001 178529355  TRIVITT          LAURA      18   21398599242          01/03/2023           1       $81.00       $0.00
       PLT2                  116931972001 178529355  TRIVITT          LAURA      18   21398599242          01/03/2023           1      $110.00      $35.70
       PLT2                  116931972001 178529355  TRIVITT          LAURA      18   21398598231          12/20/2022           1      $170.00      $35.70
       PLT2                  116931972001 178529355  TRIVITT          LAURA      18   21398598231          12/20/2022           1      $198.00      $63.14
       PLT2                  116931972001 178529355  TRIVITT          LAURA      18   21398599242          01/03/2023           1        $5.00       $0.00
       PLT2                  116931972001 178529355  TRIVITT          LAURA      18   21398598231          12/20/2022           1      $430.00      $31.83
       PLT2                  116931972001 178529355  TRIVITT          LAURA      18   21398598231          12/20/2022           8       $32.00       $0.96
       PLT2                  127519345001 178724892  GOBRECHT         ALEXANDE   18   21198755148          01/03/2023           1      $178.00      $35.70
       PLT2                  127519345001 178724892  GOBRECHT         ALEXANDE   18   21198495382          11/02/2022           1      $484.00     $142.53
       PLT2                  134917070001 181488065  WALKER           MARY       01   21598523977          12/29/2022           1      $119.00      $22.85
       PLT2                  134917070001 181488065  WALKER           MARY       01   21598596158          12/30/2022           1      $251.00      $91.85
       PLT2                  103732433001 190749713  BLACK            ACE        18   21899032422          11/04/2022           1       $37.12       $4.00
       PLT2                  103732433001 190749713  BLACK            ACE        18   21899032422          11/04/2022           1      $148.10      $13.00
       PLT2                  133541361001 197620638  RUPPERT          MATTHEW    01   22017750107          12/30/2022           1      $106.00      $60.06
       PLT2                  133541361001 197620638  RUPPERT          MATTHEW    01   22017954656          12/19/2022           1      $290.00     $130.99
       PLT2                  133541361001 197620638  RUPPERT          MATTHEW    01   22017750107          12/30/2022           1       $15.00       $0.00
       PLT2                  127519485001 197740792  ROJO OROZCO      VALERIA    19   21699192875          12/23/2022           1      $190.00      $91.85
       PLT2                  110679500001 197763806  MORENO           ERICA      18   21298136267          12/15/2022           1      $144.00     $148.53
       PLT2                  109998340001 200445452  NEIDERER         MELISSA    18   21798886179          12/29/2022           1       $25.00       $0.00
       PLT2                  109998340001 200445452  NEIDERER         MELISSA    18   21798886178          12/29/2022           1       $50.00       $0.00
       PLT2                  104629005001 201545871  ENSOR            JOHN       18   22017822189          11/12/2022           1       $76.35       $0.00
       PLT2                  104629005001 201545871  ENSOR            JOHN       18   22017822189          11/12/2022           1      $197.97       $0.00
       PLT2                  104629005001 201545871  ENSOR            JOHN       18   22017822189          11/12/2022           1      $163.10       $0.00

                                                                                                                                              PAGE:31 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT2                  105283798001 209369200  MORNINGSTAR      BELINDA    18   21798985529          11/12/2022           1       $60.75       $0.00
       PLT2                  105283798001 209369200  MORNINGSTAR      BELINDA    18   21798985529          11/12/2022           1       $35.99       $0.00
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022         900      $654.75     $347.58
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           4      $428.00     $227.20
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21298293469          12/07/2022           1       $30.00      $30.00
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           8       $43.80      $23.25
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           8       $43.80      $23.25
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           4      $750.00     $398.14
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           1    $2,912.00   $1,545.87
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022          45    $1,212.30     $643.56
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           4        $7.60       $4.03
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           4        $7.00       $3.71
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           7   $55,419.00  $29,419.84
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022          23    $3,386.36   $1,797.68
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           1      $166.00      $88.12
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           2        $2.85       $1.51
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022          15       $13.20       $7.00
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21298710177          12/22/2022           7    $1,190.00     $493.50
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21298551435          12/20/2022           1      $168.00      $66.37
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022         175    $2,132.90   $1,132.27
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           6        $9.10       $4.83
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           8       $43.80      $23.25
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022          52      $234.65     $124.56
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           1       $11.30       $5.99
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           2      $670.00     $355.67
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022         315    $2,830.25   $1,502.47
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           6    $1,158.00     $614.73
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21298710178          12/29/2022           3      $510.00     $211.50
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21298551434          12/19/2022           1      $218.00      $95.36
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           8       $43.80      $23.25
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           8       $43.80      $23.25
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           8       $27.95      $14.83

                                                                                                                                              PAGE:32 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           2        $3.05       $1.61
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022         600      $436.50     $231.72
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           1      $712.00     $377.97
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           3      $345.30     $183.30
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022         277    $8,587.00   $4,558.51
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21298551450          12/20/2022           1      $168.00      $66.37
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21298710177          12/22/2022          16      $174.59       $9.28
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21298710178          12/29/2022          16      $174.59       $9.28
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           8       $43.80      $23.25
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           8       $43.80      $23.25
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           1      $388.00     $205.97
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           8       $43.80      $23.25
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           3      $390.00     $207.03
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           1   $23,750.00  $12,607.97
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           3        $3.20       $1.69
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           8       $43.80      $23.25
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022         130      $288.60     $153.20
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022          15       $13.20       $7.00
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           4       $34.10      $18.10
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           1      $405.00     $214.99
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022          13    $3,484.00   $1,849.52
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022          20       $11.60       $6.15
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           1      $268.00     $142.27
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21298710178          12/29/2022          40    $1,811.67      $23.20
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           4        $7.60       $4.03
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           2      $802.00     $425.75
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           5      $343.00     $182.08
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           8       $43.80      $23.25
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022          58    $3,828.00   $2,032.13
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           4    $1,324.00     $703.20
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           1      $496.00     $263.30
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           8       $43.80      $23.25

                                                                                                                                              PAGE:33 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           2    $3,529.00   $1,873.41
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           8       $43.80      $23.25
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022          12      $474.30     $251.78
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           2        $3.80       $2.01
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           1      $485.00     $257.46
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022          17    $1,500.00     $796.29
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           6   $26,898.00  $14,279.12
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21298710177          12/22/2022          40    $1,811.67      $23.20
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           1        $3.70       $1.96
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           1       $33.00      $17.51
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022           8       $43.80      $23.25
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022          15      $729.00     $386.99
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022          20        $2.95       $1.56
       PLT2                  129897092001 218152854  WHITED           TIFFANY    01   21900556277          12/07/2022          15   $13,944.00   $7,402.33
       PLT2                  113019508001 236253065  CORBIN           MARCIA     01   21198567472          12/08/2022           1      $350.00      $44.80
       PLT2                  113019508001 236253065  CORBIN           MARCIA     01   21198567472          12/08/2022           1      $335.00     $114.40
       PLT2                  123271381001 341175774  RUGERIO-DE-ESPINOLAURA      18   21198770525          12/30/2022           1      $385.50       $0.00
       PLT2                  123271381001 341175774  RUGERIO-DE-ESPINOLAURA      18   21198755127          12/30/2022           1      $148.00      $67.69
       PLT2                  120434340001 352876572  GARCIA VIALET    RAYNIEL    19   21397752045          12/15/2022           1       $28.00      $11.03
       PLT2                  120434340001 352876572  GARCIA VIALET    RAYNIEL    19   21397752045          12/15/2022           1      $150.00      $60.04
       PLT2                  120434340001 352876572  GARCIA VIALET    RAYNIEL    19   21397752045          12/15/2022           1       $20.00       $5.04
       PLT2                  120434340001 352876572  GARCIA VIALET    RAYNIEL    19   21397752045          12/15/2022           1      $130.00      $89.99
       PLT2                  127520295001 544674181  DIAL             MANOLO     01   21699010911          12/29/2022           1      $178.00      $35.70
       PLT2                  127520295001 544674181  DIAL             MANOLO     01   21699010911          12/29/2022           1        $6.00       $0.00
       PLT2                  127691996001 583773933  SANTIAGO CARTAGENKIARA      19   21598539699          12/28/2022           1      $256.00     $110.50
       PLT2                  127691996001 583773933  SANTIAGO CARTAGENKIARA      19   21598539699          12/28/2022           1       $27.00      $23.20
       PLT2                  127691996001 583773933  SANTIAGO CARTAGENKIARA      19   21598539699          12/28/2022           1       $36.00      $20.20
       PLT2                  132576292001 584414035  PEREZ            JUAN       18   21198563043          12/30/2022           1      $237.00     $102.69
       PLT2                  132576292001 584414035  PEREZ            JUAN       18   21198568752          12/28/2022           1      $140.00      $96.30
       PLT2                  115162155001 637108811  GARCIA GARCIA    MARICELA   18   22017652395          12/17/2022           1       $96.00      $72.85
       PLT2                  115162155001 637108811  GARCIA GARCIA    MARICELA   18   22017652395          12/17/2022           1       $77.00      $57.18
       PLT2                  133920101001 643385508  SANCHEZ MARTINEZ ANTONIA    18   21597595289          12/08/2022           1      $125.00       $0.00

                                                                                                                                              PAGE:34 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT2                  133920101001 643385508  SANCHEZ MARTINEZ ANTONIA    18   21597595289          12/08/2022           1       $25.00       $0.00
       PLT2                  133920101001 643385508  SANCHEZ MARTINEZ ANTONIA    18   21597595289          12/08/2022           1       $69.00      $50.85
       PLT2                  133920101001 643385508  SANCHEZ MARTINEZ ANTONIA    18   21597595289          12/08/2022           1      $177.00     $392.06
       PLT2                  133920101001 643385508  SANCHEZ MARTINEZ ANTONIA    18   21597595289          12/08/2022           1       $15.00       $0.00
       PLT2                  133920101001 643385508  SANCHEZ MARTINEZ ANTONIA    18   21597595289          12/08/2022           1       $63.00       $0.00
       PLT2                  127520464001 750970007  RAMIREZ          JOEL       01   21498953644          12/30/2022           1      $352.00       $0.00
       PLT2                  127520464001 750970007  RAMIREZ          JOEL       01   21498953644          12/30/2022           1      $319.00       $0.00
       PLT2                  127520464001 750970007  RAMIREZ          JOEL       01   21498861957          12/30/2022           1      $647.00       $0.00
       PLT2                  127520464001 750970007  RAMIREZ          JOEL       01   21498861957          12/30/2022           1      $247.00      $55.99
    PLT2 Total                                                                                                                     $188,200.36  $92,709.50
    PLT3
       PLT3                  132630151001 002940399  PAYAN            ANA        18   21498489183          12/23/2022           1      $656.25     $318.60
       PLT3                  132630151001 002940399  PAYAN            ANA        18   21498841024          10/07/2022           1      $137.50      $25.13
       PLT3                  132630151001 002940399  PAYAN            ANA        18   21498841024          10/07/2022           1      $331.15      $92.25
       PLT3                  132630151001 002940399  PAYAN            ANA        18   21498841024          10/07/2022           1      $137.50      $25.13
       PLT3                  127519079001 027607293  KLECKER          MELISSA    19   21598515543          12/27/2022           1       $37.00       $9.78
       PLT3                  101212391001 159581852  FARLEY           BREELA     19   21298502697          12/27/2022           1      $177.00       $0.00
       PLT3                  101212391001 159581852  FARLEY           BREELA     19   21298502698          12/27/2022           1      $308.00      $40.10
       PLT3                  101285585001 160565498  CHRISMER         RICHARD    18   21898939505          12/09/2022           1      $424.00     $147.68
       PLT3                  127519215001 163587930  GIDICK           LILY       19   21699360050          11/30/2022           1      $247.00      $55.99
       PLT3                  110016188001 165760678  GUTIERREZ        CHRISTIN   19   21898739808          12/26/2022           1      $130.00      $89.99
       PLT3                  110016188001 165760678  GUTIERREZ        CHRISTIN   19   21898739808          12/26/2022           1      $150.00      $60.04
       PLT3                  135300725001 166700386  HERNANDEZ GUZMAN CLAUDIO    18   22017556942          09/27/2022           1      $180.00      $52.69
       PLT3                  135300725001 166700386  HERNANDEZ GUZMAN CLAUDIO    18   22017556942          09/27/2022           1        $9.00       $2.00
       PLT3                  127519241001 166829050  GARCIA           EMILIANO   01   21598750222          12/06/2022           1      $304.00     $107.86
       PLT3                  127519241001 166829050  GARCIA           EMILIANO   01   21598750222          12/06/2022           1      $431.00       $0.00
       PLT3                  110016127001 175586888  SIMMONS          MACKENZI   19   21198406578          12/27/2022           1      $178.00      $72.85
       PLT3                  110016127001 175586888  SIMMONS          MACKENZI   19   21198406578          12/27/2022           1       $77.00      $57.18
       PLT3                  102541499001 176466450  SHELLEMAN        MARTY      18   21898848157          12/26/2022           1       $20.00       $9.45
       PLT3                  102541499001 176466450  SHELLEMAN        MARTY      18   21898764434          12/14/2022           1      $150.00      $99.52
       PLT3                  102541499001 176466450  SHELLEMAN        MARTY      18   21899099903          12/22/2022           7    $1,386.00     $693.00
       PLT3                  102541499001 176466450  SHELLEMAN        MARTY      18   21898764431          11/25/2022           1      $445.00     $183.09

                                                                                                                                              PAGE:35 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT3                  102541499001 176466450  SHELLEMAN        MARTY      18   21899099905          12/29/2022           3      $594.00     $297.00
       PLT3                  102541499001 176466450  SHELLEMAN        MARTY      18   21899117445          12/27/2022           1      $150.00      $99.52
       PLT3                  102541499001 176466450  SHELLEMAN        MARTY      18   21898764432          11/27/2022           1      $150.00      $34.81
       PLT3                  102541499001 176466450  SHELLEMAN        MARTY      18   21898848157          12/26/2022           1       $98.00      $36.95
       PLT3                  102541499001 176466450  SHELLEMAN        MARTY      18   21899099905          12/29/2022           4       $21.11       $3.28
       PLT3                  102541499001 176466450  SHELLEMAN        MARTY      18   21898848157          12/26/2022           1       $41.00      $18.12
       PLT3                  102541499001 176466450  SHELLEMAN        MARTY      18   21899099903          12/22/2022          84      $233.14      $68.88
       PLT3                  102541499001 176466450  SHELLEMAN        MARTY      18   21899099905          12/29/2022          80      $222.04      $65.60
       PLT3                  102541499001 176466450  SHELLEMAN        MARTY      18   21898764433          11/28/2022           1      $150.00      $34.81
       PLT3                  102718656001 178525659  MESSINGER        RODNEY     18   22016567064          12/05/2022           1       $85.00      $35.00
       PLT3                  127519415001 187680447  RUTH             SCOTT      18   21898736673          12/27/2022           1      $109.00       $0.00
       PLT3                  110043145001 191785424  SEHAGIC          LJILJANA   18   21198637385          12/29/2022           1      $235.00      $70.81
       PLT3                  104132919001 195509503  MEHRING          EUGENIA    01   22016899366          12/09/2022           1       $20.00      $10.45
       PLT3                  104132919001 195509503  MEHRING          EUGENIA    01   22016899366          12/09/2022           1       $37.00      $22.41
       PLT3                  104132919001 195509503  MEHRING          EUGENIA    01   22016899366          12/09/2022           1       $47.00      $33.32
       PLT3                  104132919001 195509503  MEHRING          EUGENIA    01   22016899366          12/12/2022           1       $20.00      $11.87
       PLT3                  104132919001 195509503  MEHRING          EUGENIA    01   22016899366          12/09/2022           1       $20.00      $11.87
       PLT3                  104132919001 195509503  MEHRING          EUGENIA    01   22016899366          12/12/2022           1       $20.00      $10.45
       PLT3                  104132919001 195509503  MEHRING          EUGENIA    01   22016899367          12/12/2022           1       $47.00      $33.32
       PLT3                  110207069001 195620432  HOCKENSMITH      BRENDA     01   21898740273          12/23/2022           1       $90.00      $85.70
       PLT3                  110207069001 195620432  HOCKENSMITH      BRENDA     01   21899122684          12/30/2022           1       $90.00      $85.70
       PLT3                  118019314001 196603778  WILDASIN         BRISON     19   21198567365          12/30/2022           1      $197.00      $85.81
       PLT3                  104319364001 197642982  SHULTZ           JEANNIE    18   21498677755          12/29/2022           1      $360.00      $98.64
       PLT3                  104319364001 197642982  SHULTZ           JEANNIE    18   21498751988          12/29/2022           1      $115.00       $0.00
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022           1      $175.00     $112.39
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022          (1)    ($45.00)    ($16.47)
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022          (1)    ($32.00)    ($21.21)
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21799014896          01/03/2023           1      $115.00     $111.97
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022           1      $275.00     $257.94
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022          (1)    ($32.00)    ($21.21)
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21799014896          01/03/2023           1      $130.00     $125.27
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022           4      $128.00      $64.05

                                                                                                                                              PAGE:36 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022           1      $130.00     $125.27
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022          (1)   ($175.00)   ($112.39)
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022           1       $32.00      $21.21
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022           1      $115.00     $111.97
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21799014896          01/03/2023           1       $32.00      $21.21
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21799014896          01/03/2023           1      $175.00     $112.39
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022          (1)   ($275.00)   ($257.94)
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022           1       $45.00      $16.47
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022           1       $32.00      $21.21
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21799014896          01/03/2023           1       $32.00      $21.21
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21799014896          01/03/2023           1       $32.00      $21.21
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022          (1)    ($32.00)    ($21.21)
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022          (1)   ($115.00)   ($111.97)
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022          (1)   ($130.00)   ($125.27)
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022          (1)    ($32.00)    ($21.21)
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21799014896          01/03/2023           4      $128.00      $64.05
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022           1       $32.00      $21.21
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21799014896          01/03/2023           1       $45.00      $16.47
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21799014896          01/03/2023           1      $275.00     $257.94
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21794837802          10/31/2022           1       $32.00      $21.21
       PLT3                  130138891001 198199740  AVILES MONTESDEOCABIGAIL    19   21799014896          01/03/2023           1       $32.00      $21.21
       PLT3                  104567957001 200682071  GRIMES           NATHAN     19   21898923585          12/27/2022           1      $117.00      $40.65
       PLT3                  104567957001 200682071  GRIMES           LAVINA     01   21898946581          12/27/2022           1       $93.00      $79.61
       PLT3                  104567957001 200682071  GRIMES           LAVINA     01   21898923587          12/27/2022           1      $145.00      $38.56
       PLT3                  104567957001 200682071  GRIMES           LAVINA     01   21898946581          12/27/2022           1      $367.00     $313.80
       PLT3                  104567957001 200682071  GRIMES           LAVINA     01   21898923587          12/27/2022           1      $117.00      $30.99
       PLT3                  104567957001 200682071  GRIMES           NATHAN     19   21898923588          12/27/2022           1       $37.00       $8.34
       PLT3                  104567957001 200682071  GRIMES           NATHAN     19   21898923585          12/27/2022           1      $191.00      $40.65
       PLT3                  104631015001 201561854  WRIGHT           ALLEN      01   21398507374          12/05/2022           1    $1,647.00     $597.43
       PLT3                  104631015001 201561854  WRIGHT           ALLEN      01   21398507373          12/04/2022           1      $130.00      $66.37
       PLT3                  104631015001 201561854  WRIGHT           ALLEN      01   21398532805          12/29/2022           1      $506.00     $639.57
       PLT3                  104631015001 201561854  WRIGHT           ALLEN      01   21398507372          12/02/2022           1      $130.00      $66.37

                                                                                                                                              PAGE:37 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT3                  104631015001 201561854  WRIGHT           ALLEN      01   21398507373          12/04/2022           1      $511.00     $148.13
       PLT3                  104631015001 201561854  WRIGHT           ALLEN      01   21398507372          12/02/2022           1      $511.00     $148.13
       PLT3                  104631015001 201561854  WRIGHT           ALLEN      01   21398507374          12/05/2022           1      $903.00      $88.93
       PLT3                  104643309001 201628737  BROOKS           RANDY A    19   21398246540          12/26/2022           1      $150.00      $53.90
       PLT3                  104643309001 201628737  BROOKS           RANDY A    19   21398246540          12/26/2022           1       $30.00      $11.03
       PLT3                  104643309001 201628737  BROOKS           RANDY A    19   21398246540          12/26/2022           1       $30.00      $11.03
       PLT3                  104643309001 201628737  BROOKS           RANDY A    19   21398246540          12/26/2022           1      $130.00      $89.99
       PLT3                  127519540001 206720996  NOEL             KAYLIE     19   21798669677          12/20/2022           1      $430.00     $308.47
       PLT3                  127519540001 206720996  SCHRUM           HOLLY      01   21798927866          01/01/2023           1      $119.00      $72.85
       PLT3                  127519540001 206720996  SCHRUM           KEEGAN     19   21799022680          01/01/2023           1       $49.00       $0.00
       PLT3                  127519540001 206720996  SCHRUM           KEEGAN     19   21799022680          01/01/2023           1      $119.00      $22.85
       PLT3                  127519540001 206720996  SCHRUM           HOLLY      01   21798927866          01/01/2023           1       $49.00      $30.00
       PLT3                  127519540001 206720996  SCHRUM           HOLLY      01   21798927866          01/01/2023           1      $222.00     $123.00
       PLT3                  105328781001 209662233  JONES            BRAELON    19   21898745640          12/27/2022           1       $50.00      $15.18
       PLT3                  105328781001 209662233  JONES            BRAELON    19   21898788533          12/29/2022           1       $20.00      $12.22
       PLT3                  105328781001 209662233  JONES            BRAELON    19   21898772028          12/28/2022           1      $110.00      $72.85
       PLT3                  105328781001 209662233  JONES            BRAELON    19   21898772028          12/28/2022           1       $50.00      $16.60
       PLT3                  132711080001 210768627  KRESS            AMANDA     01   21598441746          12/23/2022           1       $43.00      $17.53
       PLT3                  105637507001 215905674  CLARK            WILLIAM    18   21398522198          12/08/2022           1    $1,737.75   $1,737.75
       PLT3                  105637507001 215905674  CLARK            WILLIAM    18   21398589149          12/15/2022           3        $0.24       $0.24
       PLT3                  105637507001 215905674  CLARK            WILLIAM    18   21799025694          12/23/2022           1       $73.00       $0.00
       PLT3                  105637507001 215905674  CLARK            WILLIAM    18   21398589149          12/15/2022           1    $1,216.43   $1,216.43
       PLT3                  105637507001 215905674  CLARK            WILLIAM    18   21398522198          12/08/2022           1    $2,280.80   $2,280.80
       PLT3                  105637507001 215905674  CLARK            WILLIAM    18   21799025693          01/04/2023           1       $99.00       $0.00
       PLT3                  105637507001 215905674  CLARK            WILLIAM    18   21799025694          12/23/2022           1      $300.00       $0.00
       PLT3                  105637507001 215905674  CLARK            WILLIAM    18   21398522198          12/08/2022          15        $1.20       $1.20
       PLT3                  105637507001 215905674  CLARK            WILLIAM    18   21799025695          12/30/2022           3      $237.00       $0.00
       PLT3                  105637507001 215905674  CLARK            WILLIAM    18   21398522198          12/08/2022           1    $6,690.35   $6,690.35
       PLT3                  105637507001 215905674  CLARK            WILLIAM    18   21799025695          12/30/2022           1       $99.00       $0.00
       PLT3                  105637507001 215905674  CLARK            WILLIAM    18   21799025694          12/23/2022           2      $158.00       $0.00
       PLT3                  105637507001 215905674  CLARK            WILLIAM    18   21799025693          01/04/2023           3      $237.00       $0.00
       PLT3                  105637507001 215905674  CLARK            WILLIAM    18   21398589149          12/15/2022           1    $1,824.64   $1,824.64

                                                                                                                                              PAGE:38 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT3                  127519640001 216941852  HOFFMAN          BILLIE J   01   21899135991          12/26/2022           1       $25.00      $19.21
       PLT3                  127519640001 216941852  HOFFMAN          BILLIE J   01   21899135991          12/26/2022           1       $86.00      $55.30
       PLT3                  127519640001 216941852  HOFFMAN          BILLIE J   01   21899135991          12/26/2022           1       $15.00       $0.00
       PLT3                  127519640001 216941852  HOFFMAN          BILLIE J   01   21899135991          12/26/2022           1      $111.00      $78.82
       PLT3                  127519640001 216941852  HOFFMAN          BILLIE J   01   21899135991          12/26/2022           2      $184.00     $180.89
       PLT3                  127519640001 216941852  HOFFMAN          BILLIE J   01   21899135991          12/26/2022           3      $204.00     $146.12
       PLT3                  127519640001 216941852  HOFFMAN          BILLIE J   01   21899135991          12/26/2022           1      $156.00     $117.00
       PLT3                  127519640001 216941852  HOFFMAN          BILLIE J   01   21899135991          12/26/2022           1       $55.00      $40.69
       PLT3                  127519640001 216941852  HOFFMAN          BILLIE J   01   21899135991          12/26/2022           1       $75.00      $56.25
       PLT3                  133079693001 217176821  BROOKS           CHARLES    18   21598692744          12/29/2022           1      $189.42      $40.06
       PLT3                  133079693001 217176821  BROOKS           CHARLES    18   21598692744          12/29/2022           2       $27.84       $5.28
       PLT3                  127519678001 220045976  BROOKS           ALLEN      18   21198339673          12/27/2022           1       $49.00      $30.00
       PLT3                  127519678001 220045976  BROOKS           ALLEN      18   21198339674          12/27/2022           1      $222.00     $123.00
       PLT3                  127519678001 220045976  BROOKS           ALLEN      18   21198339673          12/27/2022           1      $119.00      $72.85
       PLT3                  124836037001 598058684  SOLIS DEJESUS    GLORIS     18   21798362300          01/21/2021           1      $119.00      $64.73
       PLT3                  134248555001 634623719  PUTNAM           JOHNATHO   18   21198704261          12/27/2022           1       $75.00      $43.44
       PLT3                  134248555001 634623719  PUTNAM           JOHNATHO   18   21198704261          12/27/2022           1       $73.00      $41.67
       PLT3                  134248555001 634623719  PUTNAM           JOHNATHO   18   21198704261          12/27/2022           1      $175.00      $97.68
    PLT3 Total                                                                                                                      $34,111.36  $22,363.06
    PLT4
       PLT4                  110074814001 165687694  RINEHART         MARISSA    19   21899235502          11/24/2022           1       $37.00      $13.98
       PLT4                  101766063001 166683029  HENRY            CHRISTOP   19   21398052217          12/22/2022           1       $51.00      $15.39
       PLT4                  101766063001 166683029  HENRY            CHRISTOP   19   21398052217          12/22/2022           1      $200.00      $79.08
       PLT4                  101766063001 166683029  HENRY            CHRISTOP   19   21398052217          12/22/2022           1      $287.00      $27.63
       PLT4                  127519294001 173725317  BAKER            LEEANN     19   21498741944          12/29/2022           1      $150.00      $60.04
       PLT4                  127519294001 173725317  BAKER            LEEANN     19   21498741944          12/29/2022           1      $130.00      $89.99
       PLT4                  127519294001 173725317  BAKER            LEEANN     19   21498741944          12/29/2022           1      $175.50      $70.88
       PLT4                  134992758001 176826529  MATHIS           AURYANA    18   21397754780          11/16/2022          (1)   ($119.00)    ($22.85)
       PLT4                  134992758001 176826529  MATHIS           AURYANA    18   21397754780          11/16/2022           1      $119.00      $22.85
       PLT4                  134992758001 176826529  MATHIS           AURYANA    18   21397754780          11/16/2022          (1)    ($49.00)    ($24.00)
       PLT4                  134992758001 176826529  MATHIS           AURYANA    18   21397754780          11/16/2022           1       $49.00      $24.00
       PLT4                  134992758001 176826529  MATHIS           AURYANA    18   21397754779          11/16/2022           1       $11.00       $2.60

                                                                                                                                              PAGE:39 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT4                  134992758001 176826529  MATHIS           AURYANA    18   21397754779          11/16/2022          (1)    ($11.00)     ($2.60)
       PLT4                  103188167001 184461810  BAKER            MICHELLE   01   21898866683          05/02/2022           1      $147.84     $117.00
       PLT4                  103876644001 192521870  MCMASTER         HANNAH     19   21398451732          12/29/2022           1      $111.00      $67.50
       PLT4                  103876644001 192521870  MCMASTER         HANNAH     19   21398451732          12/29/2022           1       $15.00       $0.00
       PLT4                  103876644001 192521870  MCMASTER         HANNAH     19   21398451732          12/29/2022           1      $160.00      $93.56
       PLT4                  127519607001 214112478  MISTER           DANIEL     18   21298544670          12/28/2022           1      $133.00      $85.70
       PLT4                  127520257001 457578657  ALMAZAN          JESUS      18   21498680145          12/30/2022           1      $251.00      $85.81
       PLT4                  130166364001 499081132  NEWELL           WHITLEE    19   21393866955          10/19/2022           1       $32.00      $21.21
       PLT4                  130166364001 499081132  NEWELL           WHITLEE    19   21393866955          10/19/2022           1       $32.00      $16.02
       PLT4                  130166364001 499081132  NEWELL           WHITLEE    19   21393866955          10/19/2022           1       $32.00      $16.02
       PLT4                  130166364001 499081132  NEWELL           STETSON    19   21398445817          12/27/2022           1      $130.00      $54.99
       PLT4                  130166364001 499081132  NEWELL           WHITLEE    19   21393866955          10/19/2022           1      $275.00     $257.94
       PLT4                  130166364001 499081132  NEWELL           WHITLEE    19   21393866955          10/19/2022          (1)    ($32.00)    ($21.21)
       PLT4                  130166364001 499081132  NEWELL           WHITLEE    19   21393866955          10/19/2022           1      $115.00     $111.97
       PLT4                  130166364001 499081132  NEWELL           WHITLEE    19   21398246535          12/24/2022           1      $130.00      $54.99
       PLT4                  130166364001 499081132  NEWELL           WALKER     19   21398365903          12/29/2022           1       $96.00      $37.85
       PLT4                  130166364001 499081132  NEWELL           WHITLEE    19   21393866955          10/19/2022           1       $45.00      $16.47
       PLT4                  130166364001 499081132  NEWELL           WHITLEE    19   21393866955          10/19/2022           1      $130.00     $125.27
       PLT4                  130166364001 499081132  NEWELL           WHITLEE    19   21393866955          10/19/2022          (1)   ($275.00)   ($257.94)
       PLT4                  130166364001 499081132  NEWELL           WHITLEE    19   21393866955          10/19/2022           1      $175.00     $112.39
       PLT4                  130166364001 499081132  NEWELL           WHITLEE    19   21393866955          10/19/2022          (1)   ($115.00)   ($111.97)
       PLT4                  130166364001 499081132  NEWELL           WHITLEE    19   21393866955          10/19/2022          (1)   ($130.00)   ($125.27)
       PLT4                  130166364001 499081132  NEWELL           WHITLEE    19   21393866955          10/19/2022          (1)    ($45.00)    ($16.47)
       PLT4                  130166364001 499081132  NEWELL           WHITLEE    19   21393866955          10/19/2022          (1)   ($175.00)   ($112.39)
       PLT4                  130166364001 499081132  NEWELL           WHITLEE    19   21398246535          12/24/2022           1      $175.50      $56.70
       PLT4                  130166364001 499081132  NEWELL           WHITLEE    19   21393866955          10/19/2022           1       $32.00      $16.02
       PLT4                  130166364001 499081132  NEWELL           WALKER     19   21398504818          12/30/2022           1      $130.00      $54.99
       PLT4                  130166364001 499081132  NEWELL           STETSON    19   21398445817          12/27/2022           1       $35.00      $10.65
       PLT4                  129277059001 616488755  AMEZCUA ARCEO    ISAAC      19   21498153236          06/16/2022           1      $241.00       $0.00
       PLT4                  129358651001 720677202  HERNANDEZ MENDOZAMODESTO    18   21498359341          12/23/2022           1      $125.00      $37.48
       PLT4                  129358651001 720677202  HERNANDEZ MENDOZAMODESTO    18   21498359341          12/23/2022           1       $10.00       $0.00
       PLT4                  133599165001 775525645  LOPEZ MARTINEZ   MIGUEL     19   21699030204          12/29/2022           1       $92.00      $37.85

                                                                                                                                              PAGE:40 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT4                  133599165001 775525645  LOPEZ MARTINEZ   AZUL       19   21699030205          12/29/2022           1       $92.00      $37.85
    PLT4 Total                                                                                                                       $3,200.84   $1,237.97
    PLT5
       PLT5                  127519253001 168705901  MONFORT          SARAH KA   19   21898944759          12/28/2022           1      $115.00       $0.00
       PLT5                  127519253001 168705901  MONFORT          SARAH KA   19   21898690992          12/23/2022           1       $29.00       $8.40
       PLT5                  127519253001 168705901  MONFORT          SARAH KA   19   21898925953          12/28/2022           1      $496.00     $155.30
       PLT5                  127519253001 168705901  MONFORT          SARAH KA   19   21898690992          12/23/2022           1       $29.00       $8.40
       PLT5                  127519253001 168705901  MONFORT          SARAH KA   19   21898690992          12/23/2022           1      $132.00      $67.69
       PLT5                  127519253001 168705901  MONFORT          SARAH KA   19   21899019513          12/30/2022           1      $120.00      $88.01
       PLT5                  127519253001 168705901  MONFORT          SARAH KA   19   21899138001          01/03/2023           1      $197.00       $0.00
       PLT5                  127519253001 168705901  MONFORT          JOANNA     19   21898952287          12/30/2022           1      $132.00      $67.69
       PLT5                  102047364001 170446460  THOMAN           JUDY       01   22017822847          11/16/2022           1      $129.36       $0.00
       PLT5                  102047364001 170446460  THOMAN           JUDY       01   22017857657          12/21/2022           1      $164.00      $37.42
       PLT5                  102047364001 170446460  THOMAN           JUDY       01   22017822847          11/16/2022           2      $229.46       $0.00
       PLT5                  102052318001 170482153  BROWN            FRED       18   21498834584          12/14/2022           1      $250.00      $88.54
       PLT5                  111936259001 178567421  SHAFER           ZACHARY    19   21198401493          12/22/2022          40       $13.20      $13.20
       PLT5                  111936259001 178567421  SHAFER           ZACHARY    19   21198401493          12/22/2022          12       $52.68      $52.68
       PLT5                  104399435001 198647733  LEHIGH           CHRISTOP   18   21298477426          12/21/2022           1       $51.00      $32.30
       PLT5                  104399435001 198647733  LEHIGH           CHRISTOP   18   21298477426          12/21/2022           1       $43.00      $22.51
       PLT5                  104399435001 198647733  LEHIGH           CHRISTOP   18   21298477426          12/21/2022           1       $55.00      $34.85
       PLT5                  104399435001 198647733  LEHIGH           CHRISTOP   18   21298477426          12/21/2022           1       $15.00       $0.00
       PLT5                  104399435001 198647733  LEHIGH           CHRISTOP   18   21298477426          12/21/2022           1       $86.00      $17.07
       PLT5                  104399435001 198647733  LEHIGH           CHRISTOP   18   21298398392          12/21/2022           1      $197.00      $57.14
       PLT5                  104399435001 198647733  LEHIGH           CHRISTOP   18   21298477425          12/21/2022           1       $22.00      $48.64
       PLT5                  104875147001 204485586  FUNK             WADE       18   21198574094          12/31/2022           1       $77.00      $57.18
       PLT5                  104875147001 204485586  FUNK             WADE       18   21198574094          12/31/2022           1      $148.00     $102.69
       PLT5                  104875147001 204485586  FUNK             WADE       18   21198574094          12/31/2022           1       $49.00      $10.50
       PLT5                  127850690001 214132758  MILLER           STEPHANI   01   21298748133          01/03/2023           1      $105.00     $100.00
       PLT5                  105627122001 215627290  CORADI           ANDREW     18   21899102310          11/22/2022           1      $148.10       $0.00
       PLT5                  105627122001 215627290  CORADI           ANDREW     18   21899102310          11/22/2022           1       $39.93       $0.00
       PLT5                  105627122001 215627290  CORADI           ANDREW     18   21899102310          11/22/2022           1      $112.49       $0.00
       PLT5                  105627122001 215627290  CORADI           ANDREW     18   21899102310          11/22/2022           1       $88.07       $0.00

                                                                                                                                              PAGE:41 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT5                  105627122001 215627290  CORADI           ANDREW     18   21899102310          11/22/2022           1       $45.50       $0.00
       PLT5                  105627122001 215627290  CORADI           ANDREW     18   21899102310          11/22/2022           1       $49.54       $0.00
       PLT5                  127988292001 216929617  MCELROY          ALLEN      18   21398739903          11/15/2022           1      $358.00     $100.31
    PLT5 Total                                                                                                                       $3,778.33   $1,170.52
    PLT7
       PLT7                  133740627001 199588861  SWANBERRY        JEFFREY    18   21699080463          12/14/2022           1      $150.00      $79.93
       PLT7                  129654523001 204742674  ROTHERMEL        DUSTIN     18   21198747925          12/30/2022           1      $200.00      $96.65
       PLT7                  111255170001 205544174  CASTNER          LORI       18   21598875598          01/05/2023           1      $200.00      $85.81
       PLT7                  111255170001 205544174  CASTNER          LORI       18   21598602100          12/27/2022           1      $240.00      $39.83
       PLT7                  111255170001 205544174  CASTNER          LORI       18   21598602100          12/27/2022           1       $76.00      $12.62
    PLT7 Total                                                                                                                         $866.00     $314.84
    PLT9
       PLT9                  134530286001 012803115  TORRES           YAZERIN    18   21598637197          12/20/2022           1       $71.00       $0.59
       PLT9                  134530286001 012803115  TORRES           YAZERIN    18   21598637197          12/20/2022           1       $76.00       $0.55
       PLT9                  134530286001 012803115  TORRES           YAZERIN    18   21598637197          12/20/2022           1       $75.00       $0.55
       PLT9                  134530286001 012803115  TORRES           YAZERIN    18   21598637197          12/20/2022           1       $70.00       $0.58
       PLT9                  134530286001 012803115  TORRES           YAZERIN    18   21598637197          12/20/2022           1      $379.00       $0.45
       PLT9                  134530286001 012803115  TORRES           YAZERIN    18   21598637197          12/20/2022           2      $402.00       $0.31
       PLT9                  134530286001 012803115  TORRES           YAZERIN    18   21598637197          12/20/2022           1       $36.00       $0.59
       PLT9                  134530286001 012803115  TORRES           YAZERIN    18   21598637197          12/20/2022           1      $726.00     ($0.18)
       PLT9                  134530286001 012803115  TORRES           YAZERIN    18   21598637197          12/20/2022           1      $195.00       $0.57
       PLT9                  134530286001 012803115  TORRES           YAZERIN    18   21598637197          12/20/2022           1       $74.00       $0.57
    PLT9 Total                                                                                                                       $2,104.00       $4.58
    PLTAD
      PLTAD                  110028424001 185686509  FIELDS           IAIN       18   21498842435          12/03/2022           1       $88.07       $0.00
      PLTAD                  110028424001 185686509  FIELDS           IAIN       18   21498842435          12/03/2022           1       $74.25       $0.00
      PLTAD                  110028424001 185686509  FIELDS           IAIN       18   21498842435          12/03/2022           1      $148.10       $0.00
      PLTAD                  110028424001 185686509  FIELDS           IAIN       18   21498842435          12/03/2022           1       $45.50       $0.00
      PLTAD                  134387637001 199641389  YEAGER           RENEE      01   21697684005          12/02/2022           1      $350.00      $93.94
      PLTAD                  134387637001 199641389  YEAGER           RENEE      01   21697684005          12/02/2022           1      $350.00      $46.98
      PLTAD                  134387637001 199641389  YEAGER           RENEE      01   21698161113          12/09/2022           1      $350.00      $46.98
      PLTAD                  134387637001 199641389  YEAGER           RENEE      01   21699247220          12/15/2022           1      $338.00      $44.67

                                                                                                                                              PAGE:42 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      PLTAD                  134387637001 199641389  YEAGER           RENEE      01   21698161113          12/09/2022           1      $350.00      $93.94
      PLTAD                  134387637001 199641389  YEAGER           RENEE      01   21699247220          12/15/2022           1      $414.00     $145.04
      PLTAD                  127519500001 200746606  BECHTEL          EVELYN     19   21398445815          12/27/2022           1      $130.00      $89.99
      PLTAD                  127519500001 200746606  BECHTEL          EVELYN     19   21398445815          12/27/2022           1      $150.00      $60.04
      PLTAD                  134410999001 209667271  FRYE             MAKAYLA    19   21498602717          12/20/2022           1      $200.00     $122.86
      PLTAD                  134410999001 209667271  FRYE             MAKAYLA    19   21498602717          12/20/2022           1      $100.00       $0.00
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022           1   $16,100.00   $2,133.95
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022           9      $367.20      $48.99
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022          28      $205.36      $27.55
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022           2      $666.00      $88.58
      PLTAD                  134035475001 240618050  DANIEL-SHERMAN   TYLAN      19   21598808604          12/30/2022           1      $140.00      $17.18
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022           2       $44.00       $6.16
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022           1      $725.00      $96.40
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022           4      $791.00     $105.15
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022           2      $600.00      $79.83
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022          18    $3,338.00     $442.68
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022           2       $86.00      $11.72
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022           1      $474.00      $63.13
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022         121    $6,776.00     $898.31
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022          12    $1,245.09     $165.32
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022           1      $316.00      $42.20
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022           1    $1,300.00     $172.61
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022           2      $282.00      $37.70
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022           1      $589.00      $78.39
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022           6      $431.84      $57.55
      PLTAD                  134035475001 240618050  DANIEL           JAYANDRI   18   21598303263          12/06/2022           1      $447.00      $59.56
      PLTAD                  127520328001 579150219  BURKES           ASHLEY     01   21398469427          12/29/2022           1      $139.00      $38.34
    PLTAD Total                                                                                                                     $38,150.41   $5,415.74
    PTOHD
      PTOHD                  103785243001 191484080  MCDONALD         DARRELL    18   22016898098          05/24/2022           1      $165.00      $80.90
      PTOHD                  103785243001 191484080  MCDONALD         DARRELL    18   21698400447          12/16/2022           1    $1,352.00     $488.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           1       $67.25       $0.00

                                                                                                                                              PAGE:43 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           3      $153.00       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           1       $37.00       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           2      $375.00       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           1       $73.00       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           2      $149.25       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           2       $58.00       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           2      $102.00       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           1    $3,290.00   $6,197.73
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298544701          12/22/2022           1      $302.00     $107.86
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           1       $31.00       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           2       $98.00       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           3       $65.25       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           1       $19.50       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           1       $51.00       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           1       $31.50       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           1       $38.00       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           1       $63.00       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           1       $67.00       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           1       $55.00       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           1       $57.00       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           BRIAN      18   21298376996          12/28/2022           1      $125.00      $22.85
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           1      $330.00       $0.00
      PTOHD                  127519544001 207488327  ARENTZ           PAMELA     01   21298053965          12/13/2022           1       $91.00       $0.00
    PTOHD Total                                                                                                                      $7,245.75   $6,897.34
    RALE
       RALE                  132371997001 083720733  MAKOSIEJ         KEITH      18   21699131165          10/27/2022           1      $263.88      $79.10
       RALE                  132371997001 083720733  MAKOSIEJ         KEITH      18   21698250763          10/27/2022          (1)   ($263.88)    ($79.10)
       RALE                  127520049001 406132307  BAKER            MICHAEL    18   21398052480          12/22/2022           1      $225.00     $175.67
    RALE Total                                                                                                                         $225.00     $175.67
    RG039
      RG039                  105706221001 217984020  GROSS            RENEE      01   21699011020          12/29/2022           1       $45.00      $20.20
      RG039                  105706221001 217984020  GROSS            RENEE      01   21699011020          12/29/2022           1      $251.00      $85.81

                                                                                                                                              PAGE:44 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      RG039                  105706221001 217984020  GROSS            RENEE      01   21698676071          12/20/2022           1       $98.00      $29.56
      RG039                  105706221001 217984020  GROSS            RENEE      01   21698676071          12/20/2022           1       $10.00       $0.00
      RG039                  105706221001 217984020  GROSS            RENEE      01   21698676071          12/20/2022           1      $122.00      $27.82
      RG039                  105706221001 217984020  GROSS            RENEE      01   21698676071          12/20/2022           1       $70.00      $27.18
      RG039                  105706221001 217984020  GROSS            RENEE      01   21698676071          12/20/2022           1      $125.00      $37.48
      RG039                  105706221001 217984020  GROSS            RENEE      01   21699011020          12/29/2022           1       $38.00      $36.54
    RG039 Total                                                                                                                        $759.00     $264.59
    RWPLT
      RWPLT                  134035457001 171587917  TAYLOR           VERNON     18   21598727477          12/23/2022           1      $506.00     $184.00
      RWPLT                  134035463001 237673834  BARRON           LISA       01   21298761084          12/29/2022           1      $171.00       $3.09
      RWPLT                  134035463001 237673834  BARRON           LISA       01   21298761084          12/29/2022           1       $98.00       $3.09
      RWPLT                  134035463001 237673834  BARRON           LISA       01   21298764417          12/29/2022           1      $220.00     $146.51
      RWPLT                  134035463001 237673834  BARRON           LISA       01   21298764417          12/29/2022           1       $15.00       $1.23
      RWPLT                  134035463001 237673834  BARRON           LISA       01   21298764417          12/29/2022           1       $35.00       $1.24
      RWPLT                  134035463001 237673834  BARRON           LISA       01   21298764417          12/29/2022           1       $49.00      $19.78
      RWPLT                  134035463001 237673834  BARRON           LISA       01   21298764417          12/29/2022           1       $40.00      $22.66
      RWPLT                  134035466001 238083657  FREDELL          TIMOTHY    18   21598625196          12/28/2022           1      $300.00     $183.27
      RWPLT                  134035466001 238083657  FREDELL          TIMOTHY    18   21598892778          01/04/2023           1       $38.00      $13.25
      RWPLT                  134035466001 238083657  FREDELL          TIMOTHY    18   21598892778          01/04/2023           1       $56.00      $24.71
      RWPLT                  134035466001 238083657  FREDELL          ANDREW     19   21598806599          01/03/2023           1      $311.90      $85.30
      RWPLT                  134035466001 238083657  FREDELL          TIMOTHY    18   21598892778          01/04/2023           1      $402.00     $275.45
      RWPLT                  134035466001 238083657  FREDELL          TIMOTHY    18   21598892778          01/04/2023           1      $313.00     $190.27
      RWPLT                  134035466001 238083657  FREDELL          KRISTIE    01   21598623216          12/29/2022           1      $185.00     $124.46
      RWPLT                  134889533001 240497699  PIPPIN           EMILY      18   21898556584          12/15/2022           1      $148.10       $8.92
      RWPLT                  134889533001 240497699  PIPPIN           EMILY      18   21898966472          12/22/2022           1      $195.00      $65.64
      RWPLT                  134889533001 240497699  PIPPIN           EMILY      18   21898556584          12/15/2022           1       $88.07       $7.47
      RWPLT                  134889533001 240497699  PIPPIN           EMILY      18   21898556584          12/15/2022           1       $74.25       $7.69
      RWPLT                  134035517001 563633741  WILLIAMS         FRANK      18   21297696609          12/10/2022           7      $230.00       $0.00
      RWPLT                  134035517001 563633741  WILLIAMS         FRANK      18   21297696609          12/10/2022           8    $3,759.21       $0.00
      RWPLT                  134035517001 563633741  WILLIAMS         FRANK      18   21297696609          12/10/2022          11      $197.00       $0.00
      RWPLT                  134035517001 563633741  WILLIAMS         FRANK      18   21297696609          12/10/2022          34    $2,588.70       $0.00
      RWPLT                  134035517001 563633741  WILLIAMS         FRANK      18   21297696609          12/10/2022           2    $4,000.00       $0.00

                                                                                                                                              PAGE:45 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      RWPLT                  134035517001 563633741  WILLIAMS         FRANK      18   21298762618          12/10/2022           1      $183.00      $47.57
      RWPLT                  134035517001 563633741  WILLIAMS         FRANK      18   21297696609          12/10/2022           2    $4,460.63       $0.00
      RWPLT                  134035517001 563633741  WILLIAMS         FRANK      18   21297696609          12/10/2022           1      $472.78       $0.00
      RWPLT                  134035517001 563633741  WILLIAMS         FRANK      18   21297696609          12/10/2022           4      $419.06       $0.00
      RWPLT                  134035517001 563633741  WILLIAMS         FRANK      18   21297696609          12/10/2022           1    $2,070.61       $0.00
      RWPLT                  134035517001 563633741  WILLIAMS         FRANK      18   21297696609          12/10/2022           6      $108.20       $0.00
      RWPLT                  134035517001 563633741  WILLIAMS         FRANK      18   21297696609          12/10/2022           3      $614.68       $0.00
      RWPLT                  134035517001 563633741  WILLIAMS         FRANK      18   21297696609          12/10/2022           5    $1,529.66       $0.00
      RWPLT                  134035517001 563633741  WILLIAMS         FRANK      18   21297696609          12/10/2022           1    $2,462.00       $0.00
    RWPLT Total                                                                                                                     $26,340.85   $1,415.60
    SALES
      SALES                  127519329001 177525627  ZETTLEMOYER      KENNETH    18   21398701077          08/19/2022           1      $168.31       $0.00
      SALES                  127519329001 177525627  ZETTLEMOYER      KENNETH    18   21398616776          11/03/2022           1      $132.08       $0.00
      SALES                  127519329001 177525627  ZETTLEMOYER      KENNETH    18   21398616776          11/03/2022           1      $305.54       $0.00
      SALES                  127519329001 177525627  ZETTLEMOYER      KENNETH    18   21398616776          11/03/2022           1       $29.19       $0.00
      SALES                  105322542001 209609300  MORRIS           KEITH      18   21699111647          12/21/2022           1    $1,455.00     $609.80
      SALES                  105322542001 209609300  MORRIS           KEITH      18   21699111647          12/21/2022           1      $332.00     $110.52
      SALES                  105322542001 209609300  MORRIS           KEITH      18   21699111647          12/21/2022           1      $230.00      $76.91
    SALES Total                                                                                                                      $2,652.12     $797.23
    SBADM
      SBADM                  101985946001 169584738  HERSH            BRETT      19   21798979473          01/03/2023           1      $195.00       $0.00
    SBADM Total                                                                                                                        $195.00       $0.00
    SBSLS
      SBSLS                  101909117001 168569010  KIRCHNER         KEITH      18   21900553539          11/29/2022           4       $22.58       $0.00
      SBSLS                  101909117001 168569010  KIRCHNER         KEITH      18   21900553539          11/29/2022           2      $471.52       $0.00
      SBSLS                  101909117001 168569010  KIRCHNER         KEITH      18   21900553539          11/29/2022           1      $239.14       $0.00
      SBSLS                  101909117001 168569010  KIRCHNER         KEITH      18   21900553539          11/29/2022           2      $864.00       $0.00
      SBSLS                  101909117001 168569010  KIRCHNER         KEITH      18   21900553539          11/29/2022           4      $879.46       $0.00
      SBSLS                  101909117001 168569010  KIRCHNER         KEITH      18   21900553539          11/29/2022          12      $264.00       $0.00
      SBSLS                  101909117001 168569010  KIRCHNER         KEITH      18   21900553539          11/29/2022           1      $434.00       $0.00
      SBSLS                  101909117001 168569010  KIRCHNER         KEITH      18   21900553539          11/29/2022           1      $985.00     $165.07
      SBSLS                  101909117001 168569010  KIRCHNER         KEITH      18   21900553539          11/29/2022           1       $34.00       $5.74

                                                                                                                                              PAGE:46 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      SBSLS                  101909117001 168569010  KIRCHNER         KEITH      18   21900553539          11/29/2022           3       $14.03       $0.00
      SBSLS                  101909117001 168569010  KIRCHNER         KEITH      18   21900553539          11/29/2022           1      $296.00       $0.00
      SBSLS                  101909117001 168569010  KIRCHNER         KEITH      18   21900553539          11/29/2022           1       $26.00       $0.00
      SBSLS                  103878347001 192526922  ROBY             RONALD     18   21598829719          01/03/2023           1       $70.00       $0.00
      SBSLS                  103878347001 192526922  ROBY             RONALD     18   21598829719          01/03/2023           2      $122.00       $0.00
      SBSLS                  103878347001 192526922  ROBY             RONALD     18   21598829719          01/03/2023           1       $56.00       $0.00
      SBSLS                  103878347001 192526922  ROBY             RONALD     18   21598657153          12/29/2022           1       $56.00      $18.08
      SBSLS                  103878347001 192526922  ROBY             RONALD     18   21598657153          12/29/2022           2      $122.00      $39.33
      SBSLS                  103878347001 192526922  ROBY             RONALD     18   21598657153          12/29/2022           1       $70.00      $22.82
      SBSLS                  103878347001 192526922  ROBY             RONALD     18   21598775776          12/12/2022           1       $26.00       $7.42
    SBSLS Total                                                                                                                      $5,051.73     $258.46
    SBUNB
      SBUNB                  102771774001 179380808  MIRANDA          RICARDO    01   22017719992          12/30/2022           1       $69.00      $22.60
      SBUNB                  102771774001 179380808  MIRANDA          RICARDO    01   22017719992          12/30/2022           1       $69.00      $28.53
      SBUNB                  102771774001 179380808  MIRANDA          RICARDO    01   22017719992          12/30/2022           1       $60.00      $12.84
      SBUNB                  102771774001 179380808  MIRANDA          RICARDO    01   22017719992          12/30/2022           2      $141.00      $49.16
      SBUNB                  121488465001 184588977  MITCHELL         TAMMY      18   21398295523          12/28/2022           1       $40.00      $40.00
      SBUNB                  105062255001 206601643  LAIDIG           BROOKLYN   19   21898374230          12/19/2022          (1)   ($222.00)   ($102.70)
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1       $42.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           1       $91.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           1       $22.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1      $143.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/28/2022           1       $97.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           1    $1,708.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           1      $112.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           2      $166.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           1       $42.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/29/2022         100       $98.97       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1      $112.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1       $84.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022         100       $98.97       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/27/2022           1       $42.00       $0.00

                                                                                                                                              PAGE:47 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/27/2022          19      $637.43       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           1       $79.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           2       $43.53       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           4       $21.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21899100144          12/21/2022          15      $223.70     $165.15
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           1       $99.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           1      $103.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           1       $22.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/29/2022           1       $22.05       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           BROOKLYN   19   21898374230          12/16/2022           1      $222.00     $102.70
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022          48    $5,005.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/28/2022         100       $98.97       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           1       $42.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           3      $366.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           1      $103.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           1      $103.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/29/2022           1       $22.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/28/2022           1    $1,646.00   $3,182.31
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           1       $83.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/29/2022           8       $63.51       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1      $315.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           1       $42.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21899100144          12/21/2022           7    $3,850.00   $1,970.50
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           1       $42.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/28/2022           1       $42.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21899117601          12/13/2022           1      $500.00     $117.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           2      $244.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/28/2022           1       $42.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           8       $63.51       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           1       $85.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/29/2022          12       $38.12       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/27/2022           4       $21.00       $0.00

                                                                                                                                              PAGE:48 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022          16      $513.96       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/28/2022          18      $312.12       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/27/2022           8       $63.51       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           4       $21.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1       $42.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/28/2022           1       $99.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1      $103.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/29/2022           1       $99.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/29/2022           1       $64.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           1      $103.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           1       $86.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1      $215.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           2      $350.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/28/2022           5       $21.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           8       $63.51       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/28/2022           4       $21.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/29/2022           1       $97.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           1       $87.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022         100       $98.97       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21899100145          12/29/2022           3    $1,650.00     $844.50
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           8       $63.51       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/27/2022           1       $99.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           1       $87.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/27/2022           1       $22.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/28/2022           1       $22.05       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21899100145          12/29/2022           6       $89.48      $66.06
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21899117602          12/22/2022           1      $500.00     $117.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1       $42.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1       $91.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/29/2022           4       $21.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/27/2022           1       $97.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           1       $21.00       $0.00

                                                                                                                                              PAGE:49 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/28/2022           5       $21.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           1      $121.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1    $1,620.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/29/2022           1       $87.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           2       $78.55       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022          19      $449.18       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           1       $21.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/29/2022           1       $21.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1       $61.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1      $160.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           1      $143.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/28/2022           1       $21.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           4      $472.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1       $22.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           1       $86.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           1       $72.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           1       $87.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           4       $21.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1       $53.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           SAVANNAH   19   21898696878          07/08/2022           1    $1,000.00   $1,000.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/27/2022           1       $42.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           1       $87.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1      $143.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           1       $99.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1       $50.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           4       $21.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/27/2022           1       $21.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1       $58.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1       $86.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/24/2022           1       $22.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/28/2022           1       $22.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/27/2022         100       $98.97       $0.00

                                                                                                                                              PAGE:50 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022           1      $143.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022          15    $1,830.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/27/2022           1       $87.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/26/2022           1      $118.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/28/2022           2      $326.10       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/25/2022          18    $1,494.00       $0.00
      SBUNB                  105062255001 206601643  LAIDIG           SAVANNAH   19   21898696878          07/08/2022           8      $111.00     $111.00
      SBUNB                  105062255001 206601643  LAIDIG           NICOLE     01   21883791437          04/28/2022           1       $87.00       $0.00
      SBUNB                  105317227001 209583548  MERKEL           ANDREW     19   21198274543          12/09/2022           1       $31.00       $0.00
      SBUNB                  105317227001 209583548  MERKEL           ANDREW     19   21198274543          12/09/2022           1      $126.00       $0.00
      SBUNB                  105317227001 209583548  MERKEL           ANDREW     19   21198274543          12/09/2022           1      $202.00       $0.00
      SBUNB                  105317227001 209583548  MERKEL           ANDREW     19   21198274543          12/09/2022           1      $181.00       $0.00
      SBUNB                  105317227001 209583548  MERKEL           ANDREW     19   21198274543          12/09/2022           1       $63.00       $0.00
      SBUNB                  105317227001 209583548  MERKEL           ANDREW     19   21198274543          12/09/2022           1       $79.00       $0.00
      SBUNB                  105317227001 209583548  MERKEL           ANDREW     19   21198274543          12/09/2022           1       $72.00       $0.00
      SBUNB                  105317227001 209583548  MERKEL           ANDREW     19   21198274543          12/09/2022           1       $66.00       $0.00
      SBUNB                  105317227001 209583548  MERKEL           ANDREW     19   21198088359          12/13/2022           1      $164.04      $55.78
      SBUNB                  105317227001 209583548  MERKEL           ANDREW     19   21198274543          12/09/2022           1      $364.00       $0.00
      SBUNB                  105317227001 209583548  MERKEL           ANDREW     19   21198274543          12/09/2022           1    $1,400.00       $0.00
      SBUNB                  105317227001 209583548  MERKEL           ANDREW     19   21198274543          12/09/2022           1       $16.00       $0.00
      SBUNB                  105317227001 209583548  MERKEL           ANDREW     19   21198274543          12/09/2022           1      $137.00       $0.00
      SBUNB                  105317227001 209583548  MERKEL           ANDREW     19   21198274543          12/09/2022           1      $254.00       $0.00
      SBUNB                  105317227001 209583548  MERKEL           ANDREW     19   21198274543          12/09/2022           1      $139.00       $0.00
      SBUNB                  105317227001 209583548  MERKEL           ANDREW     19   21198274543          12/09/2022           1       $75.00       $0.00
      SBUNB                  105317227001 209583548  MERKEL           ANDREW     19   21198274543          12/09/2022           1      $180.00       $0.00
    SBUNB Total                                                                                                                     $35,682.71   $7,782.43
    SBUNM
      SBUNM                  113162058001 235231309  HOOK             CAROLINE   19   22017978689          01/04/2023           1      $105.00      $35.71
      SBUNM                  113162058001 235231309  HOOK             CAROLINE   19   22017978689          01/04/2023           1        $7.00       $3.09
    SBUNM Total                                                                                                                        $112.00      $38.80
    SLSUP
      SLSUP                  102966501001 181567932  MYERS            DIANE      18   21398606172          11/29/2022           1       $74.25       $0.00

                                                                                                                                              PAGE:51 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      SLSUP                  102966501001 181567932  MYERS            DIANE      18   21398606172          11/29/2022           1       $88.07       $0.00
      SLSUP                  114488029001 202708742  SULLIVAN         LISA       23   21198725624          12/21/2022           1       $35.00       $0.00
      SLSUP                  114488029001 202708742  SULLIVAN         LISA       23   21198725624          12/21/2022           1       $75.00      $25.00
      SLSUP                  114488029001 202708742  SULLIVAN         LISA       23   21198725624          12/21/2022           1       $45.00       $0.00
      SLSUP                  114488029001 202708742  SULLIVAN         LISA       23   21198725624          12/21/2022           1       $30.00       $0.00
      SLSUP                  114488029001 202708742  SULLIVAN         LISA       23   21198725624          12/21/2022           2       $80.00       $0.00
      SLSUP                  130726285001 213212921  LOPER            TRISTAN    19   21798752599          12/29/2022           2       $90.00      $40.40
      SLSUP                  130726285001 213212921  LOPER            TRISTAN    19   21798752599          12/29/2022           1      $194.00     $113.67
      SLSUP                  130726285001 213212921  LOPER            TRISTAN    19   21798752599          12/29/2022           1      $415.00     $292.06
      SLSUP                  130726285001 213212921  LOPER            TRISTAN    19   21798752599          12/29/2022           4       $92.00      $61.00
      SLSUP                  130726285001 213212921  LOPER            TRISTAN    19   21798752599          12/29/2022           1      $156.00     $139.33
      SLSUP                  110784636001 313864597  BRADLEY          GRACE      19   22017681589          11/21/2022           1       $46.00       $1.55
      SLSUP                  110784636001 313864597  BRADLEY          GRACE      19   22017681589          11/21/2022           1      $225.00      $64.94
      SLSUP                  110784636001 313864597  BRADLEY          GRACE      19   22017681589          11/21/2022           1       $40.00       $1.54
      SLSUP                  110784636001 313864597  BRADLEY          GRACE      19   22017681589          11/21/2022           1       $46.00       $1.55
      SLSUP                  118917218001 641129699  TRIMMER          HENRY      19   21297792925          10/13/2022           1       $40.00       $1.99
      SLSUP                  118917218001 641129699  TRIMMER          HENRY      19   21297792925          10/13/2022           1      $170.00      $18.20
      SLSUP                  118917218001 641129699  TRIMMER          HENRY      19   21297792925          10/13/2022           1       $20.00       $2.44
      SLSUP                  118917218001 641129699  TRIMMER          HENRY      19   21297792925          10/13/2022           1        $2.52       $2.81
    SLSUP Total                                                                                                                      $1,963.84     $766.48
    STVL
       STVL                  130351311001 239431510  PENDERGRASS      BARBARA    01   22017678426          12/27/2022           1       $90.00       $6.18
    STVL Total                                                                                                                          $90.00       $6.18
    TMPLT
      TMPLT                  130351292001 201643190  GELTMACHER       LOUIS      18   21898961692          12/29/2022           4      $195.00     $124.50
      TMPLT                  130351367001 522948802  BURCH            ROBERT     18   21298850060          12/29/2022           1      $184.00      $81.78
      TMPLT                  108844102001 537234616  POLICARPIO       ROBERTO    18   21198783810          12/19/2022           1       $12.60       $2.06
      TMPLT                  108844102001 537234616  POLICARPIO       ROBERTO    18   21198873427          12/19/2022           1      $170.00      $74.18
      TMPLT                  108844102001 537234616  POLICARPIO       ROBERTO    18   21198783810          12/19/2022           1       $13.25       $2.06
      TMPLT                  108844102001 537234616  POLICARPIO       ROBERTO    18   21198783810          12/19/2022           1       $39.31       $2.06
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21798865477          05/13/2022           1      $165.00      $70.86
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21799044666          06/10/2022           1      $165.00      $70.86

                                                                                                                                              PAGE:52 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21798845316          12/30/2022           1      $165.00      $70.86
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21799044633          06/23/2022           1      $165.00      $70.86
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21799044665          04/14/2022           4      $374.00      $69.51
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21799044668          06/16/2022           1      $165.00      $70.86
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21798865433          06/24/2022           1      $165.00      $70.86
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21798962311          06/03/2022           1      $165.00      $70.86
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21798865551          04/15/2022           1      $165.00      $70.86
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21799044619          04/28/2022           1      $165.00      $70.86
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21798847951          12/28/2022           2      $187.00      $37.67
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21799137784          05/19/2022           1      $165.00      $70.86
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21798962299          06/23/2022           4      $374.00      $69.51
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21798865480          04/15/2022           4      $374.00      $69.51
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21799044720          05/12/2022           1      $165.00      $70.86
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21799137806          05/27/2022           4      $374.00      $69.51
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21798852079          12/30/2022           4      $374.00      $69.51
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21798962321          04/22/2022           4      $374.00      $69.51
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21798865579          05/13/2022           4      $374.00      $69.51
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21798962310          05/06/2022           4      $374.00      $69.51
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21798865430          04/29/2022           1      $165.00      $70.86
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21799137739          04/08/2022           1      $165.00      $70.86
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21798962375          03/31/2022           4      $374.00      $69.51
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21798865478          05/20/2022           4      $374.00      $69.51
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21798962320          04/29/2022           4      $374.00      $69.51
      TMPLT                  130351390001 537272014  WHITE            SERENITY   19   21798865481          06/10/2022           4      $374.00      $69.51
      TMPLT                  130351415001 575513298  PUA              SOLINUU    18   21598889251          12/28/2022           1       $35.50      $10.43
      TMPLT                  130351415001 575513298  PUA              SOLINUU    18   21598889251          12/28/2022           1       $47.75      $12.83
      TMPLT                  130351415001 575513298  PUA              SOLINUU    18   21598889251          12/28/2022           1       $76.25       $0.77
      TMPLT                  130351415001 575513298  PUA              SOLINUU    18   21598807488          12/28/2022           1      $247.00     $148.56
      TMPLT                  130351415001 575513298  PUA              SOLINUU    18   21598889251          12/28/2022           1       $39.88      $11.62
      TMPLT                  130351415001 575513298  PUA              SOLINUU    18   21598889251          12/28/2022           1       $47.19      $13.61
      TMPLT                  130351415001 575513298  PUA              SOLINUU    18   21598889251          12/28/2022           1       $42.25       $0.77
      TMPLT                  130351415001 575513298  PUA              SOLINUU    18   21598889251          12/28/2022           1       $34.18      $10.07

                                                                                                                                              PAGE:53 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      TMPLT                  130351415001 575513298  PUA              SOLINUU    18   21598889251          12/28/2022           1       $47.25      $22.45
    TMPLT Total                                                                                                                      $8,051.41   $2,310.72
    W040
       W040                  106395294001 255088320  GRIFFIN          TERRELL    18   21398573650          12/30/2022           1       $26.00      $24.16
       W040                  106395294001 255088320  GRIFFIN          TERRELL    18   21398656989          12/30/2022           1       $64.10      $13.90
       W040                  106395294001 255088320  GRIFFIN          TERRELL    18   21398656989          12/30/2022           1    $1,050.00     $217.00
       W040                  106395294001 255088320  GRIFFIN          TERRELL    18   21398656989          12/30/2022           1       $19.60       $4.73
       W040                  106395294001 255088320  GRIFFIN          TERRELL    18   21398656989          12/30/2022           1      $252.00      $52.61
       W040                  106395294001 255088320  GRIFFIN          TERRELL    18   21398656989          12/30/2022           1    $9,351.00   $1,927.14
       W040                  106395294001 255088320  GRIFFIN          TERRELL    18   21398656989          12/30/2022           1      $786.00     $162.62
       W040                  106395294001 255088320  GRIFFIN          TERRELL    18   21398656989          12/30/2022           1      $784.00     $162.21
       W040                  106395294001 255088320  GRIFFIN          TERRELL    18   21398656989          12/30/2022           1    $2,244.00     $462.98
       W040                  106395294001 255088320  GRIFFIN          TERRELL    18   21398656989          12/30/2022           1      $374.00      $77.73
       W040                  131181056001 259861340  BARFOOT          KIM        01   21898969233          12/29/2022           1      $175.00      $34.86
    W040 Total                                                                                                                      $15,125.70   $3,139.94
  025620-01 Total                                                                                                                  $455,787.69 $178,337.98
  025620-02
    ACCTS
      ACCTS                  127519125001 083622545  FOREMAN          HALEY      18   37356725301          12/05/2022           1      $135.00       $0.00
      ACCTS                  127519125001 083622545  FOREMAN          HALEY      18   37356725301          11/07/2022           1      $135.00       $0.00
      ACCTS                  127519125001 083622545  FOREMAN          HALEY      18   37356725301          10/24/2022           1      $135.00       $0.00
      ACCTS                  113330049001 160488464  REH              JOHN       18   21698885809          12/28/2022           1      $194.00      $46.27
      ACCTS                  113330049001 160488464  REH              JOHN       18   21698885809          12/28/2022           1      $470.00     $157.86
      ACCTS                  113330049001 160488464  REH              JOHN       18   21698939140          12/21/2022           1      $120.00      $85.70
      ACCTS                  127519706001 224029868  CLARK            RICHARD    18   21298847951          12/21/2022           1      $238.00     $206.17
      ACCTS                  127519706001 224029868  CLARK            RICHARD    18   21298575359          12/19/2022           1       $36.00       $9.39
      ACCTS                  127519706001 224029868  CLARK            RICHARD    18   21298575359          12/19/2022           1       $23.00       $6.06
      ACCTS                  127519706001 224029868  CLARK            RICHARD    18   21298580959          12/19/2022           1       $18.00       $8.94
      ACCTS                  127519706001 224029868  CLARK            RICHARD    18   21298575359          12/19/2022           1       $26.00       $7.21
      ACCTS                  127519706001 224029868  CLARK            RICHARD    18   21298847951          12/21/2022           1       $60.00      $23.48
      ACCTS                  127519706001 224029868  CLARK            RICHARD    18   21298847951          12/21/2022           1       $42.00      $28.66
      ACCTS                  127519706001 224029868  CLARK            RICHARD    18   21298847951          12/21/2022           1      $190.00      $52.75

                                                                                                                                              PAGE:54 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      ACCTS                  127519706001 224029868  CLARK            RICHARD    18   21298575359          12/19/2022           1       $26.00       $6.25
      ACCTS                  127912528001 245909212  PARRISH          DELWIN     18   21198784266          12/28/2022           1      $177.00      $90.37
      ACCTS                  106519065001 263456784  DUNCAN-RIDGELY   RUTH       01   21699221497          01/01/2023           1      $234.00       $6.18
      ACCTS                  115413757001 287649586  JETT             ANDERSON   19   21799122068          01/03/2023           1      $155.00      $31.58
      ACCTS                  115413757001 287649586  JETT             ANDERSON   19   21598894967          01/03/2023           1      $150.00       $4.00
      ACCTS                  133920014001 308803100  MCCOLLUM         DEVIN      19   21598893288          01/04/2023           1      $124.65      $42.88
    ACCTS Total                                                                                                                      $2,688.65     $813.75
    ADM
        ADM                  123192878001 164740015  MATHIAS          EMILY      18   21598603829          12/29/2022           1       $40.00      $25.92
        ADM                  123192878001 164740015  MATHIAS          EMILY      18   21598603829          12/29/2022           1       $36.00      $23.23
        ADM                  123192878001 164740015  MATHIAS          EMILY      18   21598603829          12/29/2022           1       $68.00      $37.94
        ADM                  123192878001 164740015  MATHIAS          EMILY      18   21598603829          12/29/2022           1       $15.00       $0.00
        ADM                  123192878001 164740015  MATHIAS          EMILY      18   21598603829          12/29/2022           1       $69.00      $43.55
        ADM                  123192878001 164740015  MATHIAS          EMILY      18   21598603829          12/29/2022           1      $141.00      $75.35
        ADM                  102730270001 178589346  ECKERT           EUGENA     18   21498598866          12/08/2022           1       $82.30      $30.90
        ADM                  111944980001 187687590  REISINGER        DONALD     18   21198559696          12/29/2022           1       $45.00       $0.00
        ADM                  131693212001 216150151  TEWEY            BENNETT    19   21186055908          06/18/2022          (1)    ($51.00)    ($27.67)
        ADM                  131693212001 216150151  TEWEY            BENNETT    19   21198614935          06/18/2022           1      $400.00      $52.88
        ADM                  131693212001 216150151  TEWEY            BENNETT    19   21186055908          06/18/2022          (1)   ($400.00)    ($52.88)
        ADM                  131693212001 216150151  TEWEY            BENNETT    19   21198614935          06/18/2022           1      $255.00     $118.39
        ADM                  131693212001 216150151  TEWEY            BENNETT    19   21198614935          06/18/2022           1       $51.00      $27.67
        ADM                  131693212001 216150151  TEWEY            BENNETT    19   21198614935          06/18/2022           1      $295.00     $122.37
        ADM                  131693212001 216150151  TEWEY            BENNETT    19   21186055908          06/18/2022          (1)   ($295.00)   ($122.37)
        ADM                  131693212001 216150151  TEWEY            BENNETT    19   21186055908          06/18/2022          (1)    ($35.00)    ($16.56)
        ADM                  131693212001 216150151  TEWEY            AVERY      19   21198873004          12/28/2022           1      $150.00      $82.13
        ADM                  116632608001 269740942  MARSHALL         CHRISTIN   18   21699115709          12/22/2022           1      $215.00      $64.65
        ADM                  132459746001 318582322  HENDERSON        PHARIES    18   21598897010          12/29/2022          30    $3,840.00   $1,530.39
        ADM                  132459746001 318582322  HENDERSON        PHARIES    18   21598638130          12/26/2022           1    $1,668.00     $670.28
        ADM                  132459746001 318582322  HENDERSON        PHARIES    18   21598809270          12/26/2022           1      $574.00      $76.09
        ADM                  132459746001 318582322  HENDERSON        PHARIES    18   21598622903          12/29/2022           1      $534.00      $61.66
        ADM                  132459767001 335562178  CONTOS           MICHAEL    18   21899241106          12/21/2022           1      $113.00       $2.00
        ADM                  132459767001 335562178  CONTOS           MICHAEL    18   21899241106          12/21/2022           1      $209.00       $2.00

                                                                                                                                              PAGE:55 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
        ADM                  132142485001 466371278  DENTON           LISA       18   21398738336          12/20/2022           1    $1,005.72     $125.87
        ADM                  122065180001 479821106  COOTS            ALICIA     01   21798866613          12/29/2022           1      $985.00       $3.09
        ADM                  122065180001 479821106  COOTS            ALICIA     01   21798866613          12/29/2022           1      $985.00     $277.91
        ADM                  130492422001 516963327  KILBY            CURTIS     18   22017881598          12/14/2022         300      $330.00       $6.18
        ADM                  134035522001 575814384  NGUYEN           THUY       18   21799038234          12/27/2022           1      $430.00     $263.17
        ADM                  134035522001 575814384  NGUYEN           THUY       18   21799039170          12/27/2022           1       $80.00      $73.75
        ADM                  134035522001 575814384  NGUYEN           THUY       18   21799037588          12/28/2022           1      $798.00     $648.15
        ADM                  132814674001 599180857  RODRIGUEZ        KAREN      18   22017981343          12/12/2022           1      $297.00      $57.94
        ADM                  132814674001 599180857  RODRIGUEZ        KAREN      18   22017981343          12/12/2022           4      $128.00      $25.43
        ADM                  132814674001 599180857  RODRIGUEZ        KAREN      18   22017981343          12/12/2022           1      $305.00      $59.47
        ADM                  132814674001 599180857  RODRIGUEZ        KAREN      18   22017981343          12/12/2022           1       $77.00      $15.62
        ADM                  132814674001 599180857  RODRIGUEZ        KAREN      18   22017981343          12/12/2022           1       $39.00       $8.31
        ADM                  132814674001 599180857  RODRIGUEZ        KAREN      18   22017981343          12/12/2022           1    $3,210.00     $622.62
        ADM                  132814674001 599180857  RODRIGUEZ        KAREN      18   22017981343          12/12/2022           1      $134.00      $26.64
        ADM                  132814674001 599180857  RODRIGUEZ        KAREN      18   22017981343          12/12/2022           1      $186.00      $36.59
        ADM                  132814674001 599180857  RODRIGUEZ        KAREN      18   22017981343          12/12/2022           1      $111.00      $22.15
        ADM                  132814674001 599180857  RODRIGUEZ        KAREN      18   22017981343          12/12/2022           1      $788.00     $152.38
        ADM                  132814674001 599180857  RODRIGUEZ        KAREN      18   22017981343          12/12/2022           1      $435.00      $84.49
        ADM                  132814674001 599180857  RODRIGUEZ        KAREN      18   22017981343          12/12/2022           1      $136.00      $26.96
        ADM                  132814674001 599180857  RODRIGUEZ        KAREN      18   22017976951          12/12/2022           1    $1,207.00     $164.36
    ADM Total                                                                                                                       $19,686.02   $5,529.00
    AUBU
       AUBU                  127519045001 006642660  GUERRETTE        RANDY      18   21799121127          12/29/2022           1      $379.00       $3.09
       AUBU                  127519045001 006642660  GUERRETTE        RANDY      18   21799121127          12/29/2022           1      $304.00      $89.74
       AUBU                  127519045001 006642660  GUERRETTE        RANDY      18   21799123147          12/29/2022           1       $50.00       $6.18
    AUBU Total                                                                                                                         $733.00      $99.01
    CHAR
       CHAR                  127519890001 246610331  WHITE            HOPE       01   21699302501          12/29/2022           1      $354.00     $108.04
       CHAR                  127519890001 246610331  WHITE            HOPE       01   21699302501          12/29/2022           1      $687.00     $256.90
    CHAR Total                                                                                                                       $1,041.00     $364.94
    CKPT2
      CKPT2                  102308875001 173567403  SPINA            MICHAEL    18   21798617961          12/19/2022           4        $9.36       $0.00

                                                                                                                                              PAGE:56 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      CKPT2                  102308875001 173567403  SPINA            MICHAEL    18   21798617961          12/19/2022           1    $1,534.00   $1,543.36
    CKPT2 Total                                                                                                                      $1,543.36   $1,543.36
    CLARK
      CLARK                  127519828001 238991233  MARTINEZ-RAMIREZ ALEXIS     19   21799126791          11/15/2022           1       $45.00       $4.00
    CLARK Total                                                                                                                         $45.00       $4.00
    DEPT
       DEPT                  101061276001 153805816  DEFILIPPIS       JAMES      18   21699120551          10/17/2022           1      $200.00      $35.78
    DEPT Total                                                                                                                         $200.00      $35.78
    FAIR
       FAIR                  127519800001 234114855  CRALTON          ZANDER     19   21698872159          11/10/2022           1      $120.26      $29.89
       FAIR                  127519800001 234114855  CRALTON          ZANDER     19   21698872159          11/10/2022           1       $31.12      $18.21
       FAIR                  127519807001 236922363  WILES            CONNIE     01   21498978660          12/30/2022           1      $192.00     $102.33
    FAIR Total                                                                                                                         $343.38     $150.43
    FLEET
      FLEET                  102792484001 179520944  KUHN             ROY        18   21198520346          08/10/2022           5       $72.60      $27.48
      FLEET                  102792484001 179520944  KUHN             ROY        18   21198520346          08/10/2022           1    $1,452.00     $360.00
    FLEET Total                                                                                                                      $1,524.60     $387.48
    FRAZ
       FRAZ                  127519258001 169607730  HORAN            ANN        01   21498413114          11/08/2022           1      $257.00      $85.70
       FRAZ                  127519258001 169607730  HORAN            ANN        01   21498629705          12/22/2022           1       $23.00       $3.25
       FRAZ                  127519258001 169607730  HORAN            ANN        01   21498981103          12/27/2022           1    $1,302.00     $329.47
       FRAZ                  127519258001 169607730  HORAN            ANN        01   21498332086          12/22/2022           1       $49.00       $6.00
       FRAZ                  127519258001 169607730  HORAN            ANN        01   21498332086          12/22/2022           1       $49.00       $6.50
       FRAZ                  127519258001 169607730  HORAN            ANN        01   21498332086          12/22/2022           1       $46.00      $10.00
       FRAZ                  127519258001 169607730  HORAN            ANN        01   21498629705          12/22/2022           1      $185.00     $120.81
    FRAZ Total                                                                                                                       $1,911.00     $561.73
    GFPLT
      GFPLT                  127520134001 423704063  PERRYMAN         AUDREY     01   21799124362          03/16/2022           1      $151.00      $83.86
      GFPLT                  127520134001 423704063  PERRYMAN         AUDREY     01   21798843859          04/26/2022           1        $9.00       $6.18
      GFPLT                  127520134001 423704063  PERRYMAN         AUDREY     01   21799124362          03/16/2022           1      $100.00      $11.15
      GFPLT                  127520134001 423704063  PERRYMAN         AUDREY     01   21798843968          04/26/2022           1      $145.00      $89.14
      GFPLT                  127520134001 423704063  PERRYMAN         AUDREY     01   21798844257          02/08/2022           1      $145.00      $89.14

                                                                                                                                              PAGE:57 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      GFPLT                  127520136001 423922992  LAWRENCE         ROYLETTA   18   22017680415          12/29/2022           1      $100.00       $6.18
    GFPLT Total                                                                                                                        $650.00     $285.65
    HAN4
       HAN4                  110342768001 162484134  RINEER           JEFFREY    18   21598783554          12/15/2022           1      $241.00      $73.23
       HAN4                  102541730001 176467021  NEIDERER         JOHN       18   21598402251          12/23/2022           1      $562.50     $265.50
    HAN4 Total                                                                                                                         $803.50     $338.73
    HCOMP
      HCOMP                  127519321001 176645604  REDCAY           SHANNAN    18   21498843153          12/30/2022           1      $733.00     $630.43
      HCOMP                  127519321001 176645604  REDCAY           SHANNAN    18   21498834036          12/30/2022           1      $124.00      $38.56
      HCOMP                  127519321001 176645604  REDCAY           SHANNAN    18   21498843153          12/30/2022           1       $73.00      $62.78
      HCOMP                  127519321001 176645604  REDCAY           SHANNAN    18   21498834036          12/30/2022           1       $61.00      $30.99
      HCOMP                  133079696001 349645002  SHEA             THERESA    18   21899241547          12/29/2022           1      $229.00     $163.69
      HCOMP                  133079696001 349645002  SHEA             THERESA    18   21899241547          12/29/2022           1      $162.00      $67.36
    HCOMP Total                                                                                                                      $1,382.00     $993.81
    HCSLS
      HCSLS                  127970740001 350742545  HEIL             TIMOTHY    18   21198872031          12/27/2022           1      $330.00     $153.68
      HCSLS                  127970740001 350742545  HEIL             TIMOTHY    18   21198601339          12/28/2022           1       $90.75      $12.07
      HCSLS                  127970740001 350742545  HEIL             TIMOTHY    18   21198601339          12/28/2022           1      $219.75      $22.80
      HCSLS                  127970740001 350742545  HEIL             LORI       01   21198515224          12/29/2022           1       $40.00       $5.00
      HCSLS                  127970740001 350742545  HEIL             TIMOTHY    18   21198601339          12/28/2022           1      $118.75      $16.07
      HCSLS                  127970740001 350742545  HEIL             TIMOTHY    18   21198869318          01/01/2023           2       $60.52       $4.00
    HCSLS Total                                                                                                                        $859.77     $213.62
    INVIN
      INVIN                  127930871001 312680323  PETTY            CATHRYN    01   21298854538          12/29/2022           1      $240.40      $91.44
      INVIN                  127930871001 312680323  PETTY            CATHRYN    01   21298854538          12/29/2022           1       $74.55      $30.49
      INVIN                  134685341001 316944723  COLLINS          ASHTON     19   21193389938          06/28/2022           1      $135.00       $0.01
      INVIN                  134685341001 316944723  COLLINS          ASHTON     19   21193389938          06/06/2022           1      $405.00     $324.00
      INVIN                  134685341001 316944723  COLLINS          ASHTON     19   21198559423          08/29/2022           1      $125.00       $0.00
      INVIN                  134685341001 316944723  COLLINS          ASHTON     19   21193389938          06/14/2022           1      $405.00      $89.07
      INVIN                  134685341001 316944723  COLLINS          ASHTON     19   21197524132          07/05/2022           1      $270.00     $100.14
      INVIN                  134685341001 316944723  COLLINS          ASHTON     19   21197524132          07/25/2022           1      $135.00      $48.80
      INVIN                  134685341001 316944723  COLLINS          ASHTON     19   21193389938          06/28/2022           1      $270.00       $0.01

                                                                                                                                              PAGE:58 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      INVIN                  134685341001 316944723  COLLINS          ASHTON     19   21197524132          07/25/2022           1      $270.00     $100.14
      INVIN                  134685341001 316944723  COLLINS          ASHTON     19   21197524132          07/12/2022           1      $405.00     $164.00
    INVIN Total                                                                                                                      $2,734.95     $948.10
    KCSLS
      KCSLS                  131084120001 320640687  MURPHY           BILLY      18   21298849690          12/27/2022           1      $681.00     $685.00
    KCSLS Total                                                                                                                        $681.00     $685.00
    LROCK
      LROCK                  127520155001 429214680  HOWELL           GARY       18   21198869432          12/13/2022           1      $188.00     $140.76
    LROCK Total                                                                                                                        $188.00     $140.76
    MOBL
       MOBL                  107759117001 418027403  KIRKSEY          TINA       01   21298160482          12/21/2022           1      $154.00      $98.09
       MOBL                  107759117001 418027403  KIRKSEY          TINA       01   21298581713          12/19/2022           1      $310.00      $55.54
       MOBL                  107759117001 418027403  KIRKSEY          TINA       01   21298160482          12/21/2022           1      $105.00      $47.59
    MOBL Total                                                                                                                         $569.00     $201.22
    NASH
       NASH                  121950008001 411020733  SPEARS           MICHAEL    18   21899153254          12/28/2022           1      $745.51     $270.79
    NASH Total                                                                                                                         $745.51     $270.79
    NERDC
      NERDC                  134373696001 024622660  MURRAY           CAELYN     19   21699115347          10/25/2022           1        $7.00       $6.13
      NERDC                  134373696001 024622660  MURRAY           CAELYN     19   21699115347          10/25/2022           1       $40.00      $42.95
    NERDC Total                                                                                                                         $47.00      $49.08
    NEW
        NEW                  127519110001 054625237  FRISCIA          DOMINICK   18   22016524431          04/14/2021           1    $1,730.71     $854.17
    NEW Total                                                                                                                        $1,730.71     $854.17
    PLT1
       PLT1                  127519146001 120158020  MALDONADO PEDROZAOLIVIA     01   22017867094          12/29/2022           1       $84.00      $33.99
       PLT1                  127519146001 120158020  MALDONADO PEDROZAOLIVIA     01   22017867094          12/29/2022           1       $94.00      $37.39
       PLT1                  127519146001 120158020  MALDONADO PEDROZAOLIVIA     01   22017865105          12/29/2022           1      $949.00       $0.00
       PLT1                  127519146001 120158020  MALDONADO PEDROZAOLIVIA     01   22017851212          01/03/2023           1      $117.00       $0.00
       PLT1                  127519146001 120158020  MALDONADO PEDROZAOLIVIA     01   22017865105          12/29/2022           1      $498.00     $488.00
       PLT1                  117427753001 215705984  MARTIN           DOROTHY    01   21198594602          12/27/2022           1       $29.00      $14.96
       PLT1                  117427753001 215705984  MARTIN           DOROTHY    01   21198597127          12/27/2022           1       $63.00      $24.91

                                                                                                                                              PAGE:59 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT1                  117427753001 215705984  MARTIN           DOROTHY    01   21198597127          12/27/2022           1       $80.00      $31.37
       PLT1                  117427753001 215705984  MARTIN           MICHAEL    18   21198784892          01/03/2023           1      $750.00      $43.11
    PLT1 Total                                                                                                                       $2,664.00     $673.73
    PLT18
      PLT18                  107801098001 421173069  ADAMS            STEPHANI   19   21799126207          12/15/2022           1      $150.00      $30.62
      PLT18                  107801098001 421173069  ADAMS            STEPHANI   19   21799126207          12/15/2022           1       $45.00       $3.09
    PLT18 Total                                                                                                                        $195.00      $33.71
    PLT2
       PLT2                  102403917001 174647663  SNYDER           SUSAN      18   22016508640          12/14/2022           1       $59.00      $26.66
       PLT2                  130351279001 178802635  LUA GARCIA       ALICIA     18   21498680111          12/29/2022           1      $376.00      $84.19
       PLT2                  127519442001 190804756  AGUILAR SANTANA  ALEX       19   21898867519          12/23/2022           1       $18.00       $7.10
       PLT2                  103967108001 193561407  DEAVEN           BRIANNA    19   21898939546          12/22/2022           1      $161.00      $12.82
       PLT2                  103967108001 193561407  DEAVEN           BRIANNA    19   21898939546          12/23/2022           1       $70.00      $25.44
       PLT2                  103967108001 193561407  DEAVEN           BRIAN      18   21899239227          12/29/2022           1      $199.00      $50.87
       PLT2                  103967108001 193561407  DEAVEN           BRIANNA    19   21899122483          12/28/2022           1    $1,973.00     $781.59
       PLT2                  103967108001 193561407  DEAVEN           BRIAN      18   21899235098          01/02/2023           1      $199.00      $50.87
       PLT2                  127519459001 193580895  SCHWARTZ         DANIEL     18   21798927904          01/01/2023           1       $18.00       $0.00
       PLT2                  127519459001 193580895  SCHWARTZ         DANIEL     18   21798927905          01/01/2023           1       $24.00       $0.00
       PLT2                  105317927001 209585807  WOLF             CHRIS      18   22016567069          11/04/2022           1       $85.00      $35.00
    PLT2 Total                                                                                                                       $3,182.00   $1,074.54
    PLT3
       PLT3                  101821520001 167544845  MASIMORE         ANGIE      18   21298473067          11/23/2022           1      $319.00      $98.14
       PLT3                  101821520001 167544845  MASIMORE         ANGIE      18   21298473067          11/23/2022           1      $843.00      $86.14
       PLT3                  101911905001 168587693  MALZI            RUSSELL    18   22017581564          12/28/2022           1      $180.00      $52.69
       PLT3                  101911905001 168587693  MALZI            RUSSELL    18   22017581564          12/28/2022           1       $53.00       $0.00
       PLT3                  101911905001 168587693  MALZI            RUSSELL    18   22017639818          12/28/2022           1       $42.00       $0.00
       PLT3                  101911905001 168587693  MALZI            RUSSELL    18   22017581564          12/28/2022           1       $49.00       $0.00
       PLT3                  101911905001 168587693  MALZI            RUSSELL    18   22017652372          12/28/2022           1      $484.00       $0.00
       PLT3                  101911905001 168587693  MALZI            RUSSELL    18   22017573780          12/28/2022           1       $39.00       $0.00
       PLT3                  101924046001 168669964  STROUSE          KALEB      19   22017441209          12/23/2022           1      $150.00      $58.28
       PLT3                  101924046001 168669964  STROUSE          JAMIE      18   22017210515          12/18/2022           1      $275.00     $275.00
       PLT3                  109996040001 175560842  GINTER           WINDY      18   21298545831          12/30/2022           1      $130.66      $22.60

                                                                                                                                              PAGE:60 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT3                  109996040001 175560842  GINTER           WINDY      18   21298492404          12/28/2022           1       $98.03      $28.53
       PLT3                  109996040001 175560842  GINTER           WINDY      18   21298545831          12/30/2022           1       $98.03      $24.58
       PLT3                  109996040001 175560842  GINTER           WINDY      18   21298492404          12/28/2022           1      $130.66      $22.60
       PLT3                  109996040001 175560842  GINTER           WINDY      18   21298545831          12/30/2022           1       $98.03      $28.53
       PLT3                  109996040001 175560842  GINTER           WINDY      18   21298492404          12/28/2022           1       $98.03      $24.58
       PLT3                  105300375001 209483752  PEREZ            JOYEL      01   21699010910          12/19/2022           1    $1,484.00     $547.27
       PLT3                  132273202001 214782497  SWAIN            GLEN       18   21498702299          12/20/2022           1      $144.30     $106.15
       PLT3                  127519630001 216138447  DIGRUTTOLA       SONIA      18   21799022662          01/03/2023           1      $119.00      $35.70
       PLT3                  133505109001 323613638  RIVERA ACOSTA    EVELIN     18   22017645408          12/13/2022           1      $198.00     $110.50
       PLT3                  129925718001 574508518  EOGNUK           LENA       18   21899135993          12/30/2022           1       $27.00      $20.58
    PLT3 Total                                                                                                                       $5,059.74   $1,541.87
    PLT4
       PLT4                  128097148001 116674587  HELD             RALPH      01   21498773302          11/03/2022           1      $103.00      $42.00
       PLT4                  128097148001 116674587  HELD             RALPH      01   21498841500          11/17/2022           1      $103.00      $42.00
       PLT4                  128097148001 116674587  HELD             RALPH      01   21498841500          11/17/2022           1      $120.00      $61.88
       PLT4                  128097148001 116674587  HELD             RALPH      01   21498070674          12/15/2022           4      $336.00     $284.78
       PLT4                  128097148001 116674587  HELD             RALPH      01   21498773302          11/03/2022           1      $120.00      $61.88
       PLT4                  127519375001 182444782  BELL             DEBORAH    18   21498777880          12/29/2022           1      $189.42      $40.06
       PLT4                  127519375001 182444782  BELL             DEBORAH    18   21498777880          12/29/2022           2       $27.84       $5.28
       PLT4                  127519375001 182444782  BELL             DEBORAH    18   21498854423          10/25/2022           1      $109.66      $36.28
       PLT4                  127519375001 182444782  BELL             DEBORAH    18   21498854423          10/25/2022           1      $130.87      $33.50
       PLT4                  122785144001 189862244  CARDENAS         JOSE       18   21799053285          12/28/2022           1      $186.14      $44.80
       PLT4                  122785144001 189862244  CARDENAS         JOSE       18   21799053285          12/28/2022           1      $546.00      $66.00
       PLT4                  104904003001 204668323  SERRANO          CITLALY    19   21398205420          12/21/2022           1      $141.00     $183.77
       PLT4                  104904003001 204668323  SERRANO          CITLALY    19   21398205420          12/21/2022           1      $430.00     $308.47
       PLT4                  104904003001 204668323  SERRANO          KASY       18   21398451733          12/26/2022           1      $430.00     $308.47
       PLT4                  105059573001 206583705  RIDDLE           DAVID      18   21899001015          12/27/2022           1       $50.00       $4.19
       PLT4                  127519600001 213154524  ROBERTS          COOPER     19   21498956778          01/04/2023           1       $73.00       $0.00
       PLT4                  131392806001 237020643  INGRAM           JAMES      18   21698940864          12/25/2022           1       $35.00       $8.03
       PLT4                  131392806001 237020643  INGRAM           JAMES      18   21698922843          12/25/2022           1       $39.00       $8.05
       PLT4                  131392806001 237020643  INGRAM           JAMES      18   21698940864          12/25/2022           1      $347.00      $80.57
       PLT4                  131392806001 237020643  INGRAM           JAMES      18   21699089842          12/25/2022           1      $484.00     $167.67

                                                                                                                                              PAGE:61 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       PLT4                  135185754001 501191096  OLSON            STEVEN     18   21398437271          12/31/2022           1      $119.00      $22.85
       PLT4                  135185754001 501191096  OLSON            STEVEN     18   21398437271          12/31/2022           1       $49.00       $0.00
    PLT4 Total                                                                                                                       $4,168.93   $1,810.53
    PLT5
       PLT5                  102403081001 174644833  PLANK            TRAVIS     18   21198602265          12/29/2022           1      $210.00      $94.16
       PLT5                  127519358001 180508597  BARTHOLD         ROBERT     18   21598777555          12/28/2022           1       $54.00      $12.14
       PLT5                  109570579001 594529865  LACEY            DYLAN      19   21798749752          11/30/2022           1      $134.00      $89.57
       PLT5                  109570579001 594529865  LACEY            DYLAN      19   21798749752          11/30/2022           1      $134.00     $154.02
    PLT5 Total                                                                                                                         $532.00     $349.89
    PLT7
       PLT7                  110600788001 156748709  APPLEGATE        CHRISTIN   01   21498859186          01/03/2023           1      $460.00     $139.00
       PLT7                  102130765001 171461774  CAVELLO          JOSEPH     18   21797930903          12/05/2022           1      $267.00     $210.12
       PLT7                  102130765001 171461774  CAVELLO          JOSEPH     18   21797930903          12/05/2022           1       $97.00      $50.51
       PLT7                  127520258001 460253601  WIGGINS          MICHELLE   01   21598834131          01/04/2023           1      $250.00     $100.00
    PLT7 Total                                                                                                                       $1,074.00     $499.63
    PLT9
       PLT9                  127519056001 015525026  KILCOYNE         THOMAS     18   22017978270          12/30/2022           1      $264.06      $42.36
       PLT9                  127519056001 015525026  KILCOYNE         THOMAS     18   22017971928          12/30/2022           1      $148.10      $23.62
       PLT9                  127519082001 028725108  GUICHARD         JESSICA    18   21899234579          12/23/2022           1      $119.53      $34.14
       PLT9                  127519082001 028725108  GUICHARD         JESSICA    18   21899234579          12/23/2022           1      $130.87      $44.21
    PLT9 Total                                                                                                                         $662.56     $144.33
    PLTAD
      PLTAD                  127519129001 091338859  HUERTA-BARRERA   DAVID      19   21198725385          01/02/2023           1      $130.00      $54.99
      PLTAD                  127519129001 091338859  HUERTA-BARRERA   JACOB      19   21198575834          12/28/2022           1      $130.00      $54.99
      PLTAD                  127519129001 091338859  HUERTA RAMIREZ   MARCO      18   21198634838          12/28/2022           1       $25.00      $17.93
      PLTAD                  127519129001 091338859  HUERTA RAMIREZ   NANCY      01   21198634837          12/29/2022           1       $50.00      $26.66
      PLTAD                  127519129001 091338859  HUERTA RAMIREZ   MARCO      18   21198634838          12/28/2022           1       $50.00      $26.66
      PLTAD                  101119148001 156761398  KISSANE          JENNIFER   01   21898522865          12/20/2022           1      $516.00     $241.43
      PLTAD                  101119148001 156761398  KISSANE          JENNIFER   01   21898522865          12/20/2022           1      $131.00      $61.25
      PLTAD                  101119148001 156761398  KISSANE          MOLLY      19   21898789001          12/21/2022           4      $148.00     $111.20
      PLTAD                  134647658001 310906130  KACEDAN          THOMAS     19   21898980992          12/27/2022           1       $52.00      $12.82
      PLTAD                  134647658001 310906130  KACEDAN          THOMAS     19   21898980992          12/27/2022           1      $223.00      $51.39

                                                                                                                                              PAGE:62 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      PLTAD                  134647658001 310906130  KACEDAN          THOMAS     19   21898980992          12/27/2022           1      $105.00      $24.78
      PLTAD                  134647658001 310906130  KACEDAN          THOMAS     19   21898980992          12/27/2022           1      $137.00      $31.99
      PLTAD                  134647658001 310906130  KACEDAN          THOMAS     19   21898980992          12/27/2022           1      $252.00      $57.94
      PLTAD                  134647658001 310906130  KACEDAN          THOMAS     19   21899234384          12/27/2022           1       $65.00      $35.01
      PLTAD                  134647658001 310906130  KACEDAN          THOMAS     19   21898980992          12/27/2022           1      $138.00      $32.22
      PLTAD                  134647658001 310906130  KACEDAN          THOMAS     19   21898980992          12/27/2022           1      $319.00      $73.06
      PLTAD                  134647658001 310906130  KACEDAN          BRIDGET    19   21899237516          01/04/2023           1      $157.00      $54.36
      PLTAD                  134647658001 310906130  KACEDAN          THOMAS     19   21898980992          12/27/2022           1      $189.00      $43.72
      PLTAD                  134647658001 310906130  KACEDAN          THOMAS     19   21898980992          12/27/2022           1      $347.00      $79.38
    PLTAD Total                                                                                                                      $3,164.00   $1,091.78
    PROV
       PROV                  100568043001 109507287  LANSING          KAREN      01   22017696669          12/12/2022           1      $415.00     $100.97
       PROV                  100568043001 109507287  LANSING          KAREN      01   22017684014          12/23/2022           1       $15.14       $5.84
       PROV                  100568043001 109507287  LANSING          KAREN      01   22017684014          12/23/2022           1       $14.79       $5.73
       PROV                  100568043001 109507287  LANSING          KAREN      01   22017679575          12/12/2022           1      $132.00      $68.23
       PROV                  100568043001 109507287  LANSING          KAREN      01   22017684014          12/23/2022           1       $14.63       $5.69
       PROV                  100568043001 109507287  LANSING          KAREN      01   22017684014          12/23/2022           1       $75.37       $5.73
       PROV                  100568043001 109507287  LANSING          KAREN      01   22017684014          12/23/2022           1       $45.50       $8.15
       PROV                  100568043001 109507287  LANSING          KAREN      01   22017684014          12/23/2022           1       $14.17       $5.53
       PROV                  100568043001 109507287  LANSING          KAREN      01   22017684014          12/23/2022           1       $37.12       $3.41
    PROV Total                                                                                                                         $763.72     $209.28
    PTOHD
      PTOHD                  101827091001 167581418  SANDERS          SUE        01   21298641526          12/27/2022           1      $181.00     $196.74
      PTOHD                  101827091001 167581418  SANDERS          SUE        01   21298641526          12/27/2022           1      $144.00     $148.53
      PTOHD                  113097580001 196608181  YOUNG            AIYANA     19   21798650286          12/28/2022           1      $178.00      $70.81
    PTOHD Total                                                                                                                        $503.00     $416.08
    RALE
       RALE                  127519130001 091546399  WHITAKER         TIFFANY    01   21298763550          12/21/2022           1      $190.00     $120.14
       RALE                  127519130001 091546399  WHITAKER         TIFFANY    01   21298592216          09/20/2022           1    $1,555.00     $977.30
       RALE                  127519130001 091546399  WHITAKER         TIFFANY    01   21298862435          09/18/2022           1      $277.00     $259.77
       RALE                  127519130001 091546399  WHITAKER         TIFFANY    01   21298592213          09/19/2022           1    $2,458.00   $1,622.51
       RALE                  127519130001 091546399  WHITAKER         TIFFANY    01   21293404065          09/18/2022          (1)   ($277.00)   ($259.77)

                                                                                                                                              PAGE:63 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       RALE                  127519130001 091546399  WHITAKER         TIFFANY    01   21298851803          12/13/2022           1      $229.00     $122.74
       RALE                  127519130001 091546399  WHITAKER         TIFFANY    01   21298862438          09/19/2022           1    $3,715.00   $1,147.43
       RALE                  127519130001 091546399  WHITAKER         TIFFANY    01   21298763550          12/21/2022           1       $97.00      $58.65
       RALE                  127519130001 091546399  WHITAKER         TIFFANY    01   21298763550          12/21/2022           1      $215.00     $159.07
       RALE                  127519130001 091546399  WHITAKER         TIFFANY    01   21298761503          12/29/2022           1      $425.00     $244.32
       RALE                  127519130001 091546399  WHITAKER         TIFFANY    01   21298763550          12/21/2022           8       $24.00      $11.87
       RALE                  127519130001 091546399  WHITAKER         TIFFANY    01   21293493379          09/20/2022          (1) ($1,555.00)   ($977.30)
    RALE Total                                                                                                                       $7,353.00   $3,486.73
    RWPLT
      RWPLT                  128369168001 245458767  DAVENPORT        JASON      18   21899069115          12/28/2022           1      $461.00     $223.20
      RWPLT                  134035494001 330648800  HICKMAN          DAVID      18   21699117585          12/29/2022           1      $186.98      $15.00
      RWPLT                  134035502001 497839651  GARCIA           GRACIELA   18   21598893083          12/29/2022           1      $300.00     $183.27
      RWPLT                  134035502001 497839651  GARCIA           GRACIELA   18   21598808075          01/03/2023           1       $83.00       $3.09
      RWPLT                  134035502001 497839651  GARCIA           GRACIELA   18   21598808075          01/03/2023           1      $237.00      $95.12
      RWPLT                  134035502001 497839651  GARCIA           GRACIELA   18   21598889719          12/29/2022           1       $66.00      $11.81
    RWPLT Total                                                                                                                      $1,333.98     $531.49
    SALES
      SALES                  100083042001 010541503  VILLAR           NATALIE    18   22017503458          12/21/2022           1      $139.00      $73.80
      SALES                  100083042001 010541503  VILLAR           NATALIE    18   22009869207          09/01/2022          (1)   ($478.00)   ($355.23)
      SALES                  100083042001 010541503  VILLAR           NATALIE    18   22009869207          09/01/2022          (2)   ($180.00)   ($119.17)
      SALES                  100083042001 010541503  VILLAR           NATALIE    18   22017677338          12/30/2022           1      $161.00      $87.72
      SALES                  100083042001 010541503  VILLAR           NATALIE    18   22009869207          09/01/2022          (1)   ($150.00)    ($79.52)
      SALES                  100083042001 010541503  VILLAR           NATALIE    18   22017503458          12/21/2022           1      $100.00      $84.02
      SALES                  100083042001 010541503  VILLAR           NATALIE    18   22017679747          12/29/2022           1       $75.00      $54.68
      SALES                  100083042001 010541503  VILLAR           NATALIE    18   22009869207          09/01/2022          (1)     ($8.00)     ($6.76)
      SALES                  100083042001 010541503  VILLAR           NATALIE    18   22009869207          09/01/2022          (1)     ($2.00)     ($2.15)
      SALES                  100289216001 059403484  MOONEY           PATRICK    18   21298157832          12/22/2022           1       $65.00      $14.43
      SALES                  100289216001 059403484  MOONEY           PATRICK    18   21298157832          12/22/2022           1      $300.00      $76.00
      SALES                  100289216001 059403484  MOONEY           PATRICK    18   21298157832          12/22/2022           1       $25.00      $26.00
      SALES                  100289216001 059403484  MOONEY           NANCY      01   21298761345          12/05/2022           1    $2,387.50     $359.69
      SALES                  100289216001 059403484  MOONEY           PATRICK    18   21298157832          12/22/2022           1       $65.00      $14.45
      SALES                  127519164001 142925038  REESE            ELIZABET   19   22017505553          12/19/2022           1      $125.00      $95.43

                                                                                                                                              PAGE:64 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      SALES                  127519164001 142925038  REESE            THOMAS     19   22017975809          12/21/2022           1      $125.00      $95.43
    SALES Total                                                                                                                      $2,749.50     $418.82
    SBSLS
      SBSLS                  130492401001 279624159  HYRNE            JACOB      19   21699117041          12/23/2022           1      $105.00      $58.61
      SBSLS                  130492401001 279624159  HYRNE            ETHAN      19   21698691165          12/16/2022           1      $200.00       $1.03
      SBSLS                  130492401001 279624159  HYRNE            ETHAN      19   21698691165          12/16/2022           1      $420.00       $1.03
      SBSLS                  130492401001 279624159  HYRNE            RANDALL    18   21699119527          12/29/2022           1       $45.00      $17.81
      SBSLS                  130492401001 279624159  HYRNE            ETHAN      19   21698691165          12/16/2022           1      $505.00       $1.03
      SBSLS                  130492401001 279624159  HYRNE            ETHAN      19   21698691165          12/16/2022           1      $420.00       $1.03
      SBSLS                  130492401001 279624159  HYRNE            ETHAN      19   21698691165          12/16/2022           1      $505.00       $1.03
      SBSLS                  130492401001 279624159  HYRNE            ETHAN      19   21698691165          12/16/2022           1      $200.00       $1.03
      SBSLS                  130492401001 279624159  HYRNE            RANDALL    18   21699119527          12/29/2022           2       $90.00      $35.04
    SBSLS Total                                                                                                                      $2,490.00     $117.64
    SBUNB
      SBUNB                  135138712001 200404534  BAKER            THOMAS     18   21498622558          12/27/2022           1      $156.00      $50.70
    SBUNB Total                                                                                                                        $156.00      $50.70
    SBUNM
      SBUNM                  104051820001 194527382  BOLDEN           EDGAR      18   21398032818          12/22/2022           1      $421.00     $275.82
      SBUNM                  104051820001 194527382  BOLDEN           EDGAR      18   21397709587          12/16/2022           1    $2,777.00     $683.71
      SBUNM                  104051820001 194527382  BOLDEN           EDGAR      18   21398442494          12/30/2022           1      $124.00      $68.43
      SBUNM                  104051820001 194527382  BOLDEN           EDGAR      18   21397709587          12/16/2022          20      $650.21       $0.00
      SBUNM                  104051820001 194527382  BOLDEN           EDGAR      18   21398290370          12/24/2022           1      $215.00     $172.00
      SBUNM                  104051820001 194527382  BOLDEN           EDGAR      18   21398032818          12/22/2022           1      $215.00     $201.15
    SBUNM Total                                                                                                                      $4,402.21   $1,401.11
    SLSUP
      SLSUP                  100979691001 149526025  AMATO            JANET      01   21699016013          12/29/2022           1       $50.00      $33.10
      SLSUP                  100979691001 149526025  AMATO            JANET      01   21699016013          12/29/2022           1      $165.00      $90.10
      SLSUP                  101425374001 162464543  BIGELOW          ELLEN      18   22017756721          12/30/2022           1      $512.16     $108.29
      SLSUP                  101425374001 162464543  BIGELOW          ELLEN      18   22017756721          12/30/2022           3      $568.26     $120.17
      SLSUP                  110063942001 165404878  MORGAN           WANDA      18   21898884986          12/30/2022           1       $83.85      $40.06
      SLSUP                  110063942001 165404878  MORGAN           WANDA      18   21898884985          12/30/2022           2       $18.50       $5.28
      SLSUP                  127519518001 203640623  ILGEN            JASON      18   21398373125          12/29/2022           1       $40.00      $20.20

                                                                                                                                              PAGE:65 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      SLSUP                  127519518001 203640623  ILGEN            JASON      18   21398373125          12/29/2022           1       $36.00      $24.36
      SLSUP                  127930888001 384943026  PAYNE            ANGELA     18   21198869341          12/12/2022           1      $220.00      $62.62
      SLSUP                  135588578001 493906680  ABSHEAR          JOHN       18   21598618892          12/20/2022           1       $55.00       $0.77
      SLSUP                  135588578001 493906680  ABSHEAR          JOHN       18   21598618892          12/20/2022           1       $16.00       $0.77
      SLSUP                  135588578001 493906680  ABSHEAR          JOHN       18   21598618892          12/20/2022           1       $43.00       $0.77
      SLSUP                  135588578001 493906680  ABSHEAR          JOHN       18   21598618892          12/20/2022           1       $89.00      $20.14
      SLSUP                  135588578001 493906680  ABSHEAR          JOHN       18   21598618892          12/20/2022           1      $115.00       $0.77
      SLSUP                  135588578001 493906680  ABSHEAR          JOHN       18   21598618892          12/20/2022           1       $59.00      $14.88
      SLSUP                  135588578001 493906680  ABSHEAR          JOHN       18   21598618892          12/20/2022           1       $26.00       $0.77
      SLSUP                  135588578001 493906680  ABSHEAR          JOHN       18   21598618892          12/20/2022           1       $55.00       $0.77
    SLSUP Total                                                                                                                      $2,151.77     $543.82
    TMPLT
      TMPLT                  130351394001 537626748  FINLAYSON        DAVID      18   21298579690          11/22/2022           1      $138.50      $54.27
      TMPLT                  130351394001 537626748  FINLAYSON        DAVID      18   21298577900          11/22/2022           1      $517.00     $202.32
      TMPLT                  130351394001 537626748  FINLAYSON        DAVID      18   21298573252          11/22/2022           1      $606.00     $387.62
      TMPLT                  130351414001 575060240  DUCOT            TERRY      18   21498710917          12/28/2022           1       $52.00      $30.85
      TMPLT                  130351414001 575060240  DUCOT            TERRY      18   21498710917          12/28/2022           1       $47.00      $33.67
    TMPLT Total                                                                                                                      $1,360.50     $708.73
    TUSC
       TUSC                  127520126001 423068828  LANCASTER        KENNETH    18   21899151613          12/14/2022           1       $89.00       $9.19
       TUSC                  127520126001 423068828  LANCASTER        KENNETH    18   21899151613          12/14/2022           1       $98.00      $12.85
       TUSC                  127520126001 423068828  LANCASTER        KENNETH    18   21899151613          12/14/2022           1       $75.00       $4.67
       TUSC                  127520126001 423068828  LANCASTER        KENNETH    18   21899151613          12/14/2022           1      $168.00       $9.01
    TUSC Total                                                                                                                         $430.00      $35.72
    WALD
       WALD                  105531097001 212648733  GRAY             WILLIAM    18   21498703192          12/20/2022           1    $1,750.77     $299.22
       WALD                  105763542001 219722904  KEYSER           BILLY      18   21699300622          12/30/2022           1      $620.00     $100.94
       WALD                  105763542001 219722904  KEYSER           BILLY      18   21699114494          12/20/2022           1    $1,822.23     $387.33
       WALD                  105763542001 219722904  KEYSER           BILLY      18   21699390075          10/31/2022           1    $3,864.00   $1,536.18
    WALD Total                                                                                                                       $8,057.00   $2,323.67
    WEVR
       WEVR                  131796703001 591437088  KREINER          ERIK       18   21198181703          12/15/2022           1       $46.00       $3.09

                                                                                                                                              PAGE:66 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
       WEVR                  131796703001 591437088  KREINER          ERIK       18   21198181703          12/15/2022           1       $66.00       $3.09
    WEVR Total                                                                                                                         $112.00       $6.18
    WORC
       WORC                  127519081001 028607574  COTE             DEBRA      01   21799121893          12/12/2022           3      $270.00     $111.80
       WORC                  127519081001 028607574  COTE             DEBRA      01   21799125549          12/12/2022           3      $600.00     $110.11
    WORC Total                                                                                                                         $870.00     $221.91
    ZALA
       ZALA                  108015416001 435351754  DUCOTE           DANNY      18   21899243802          12/31/2022           1       $55.00       $2.39
       ZALA                  108015416001 435351754  DUCOTE           DANNY      18   21899243802          12/31/2022           1       $13.00       $1.89
       ZALA                  108015416001 435351754  DUCOTE           DANNY      18   21899243802          12/31/2022           1       $66.00       $2.52
       ZALA                  108015416001 435351754  DUCOTE           DANNY      18   21899243802          12/31/2022           1       $34.00       $2.09
       ZALA                  108015416001 435351754  DUCOTE           DANNY      18   21899243802          12/31/2022           1       $35.00       $2.11
       ZALA                  108015416001 435351754  DUCOTE           DANNY      18   21899243802          12/31/2022           1       $67.00       $2.53
       ZALA                  132409592001 587081790  MCINTYRE         JOE        18   21899071571          12/30/2022           1      $135.00      $83.47
       ZALA                  132409592001 587081790  MCINTYRE         JOE        18   21899071571          12/30/2022           1       $61.00      $33.94
       ZALA                  132409592001 587081790  MCINTYRE         JOE        18   21899149960          12/29/2022           4      $232.00     $165.51
       ZALA                  132409592001 587081790  MCINTYRE         JOE        18   21899150024          12/27/2022           4      $232.00     $165.51
       ZALA                  132409592001 587081790  MCINTYRE         JOE        18   21899071571          12/30/2022           2       $38.00      $15.84
    ZALA Total                                                                                                                         $968.00     $477.80
  025620-02 Total                                                                                                                   $94,510.36  $32,640.10
  025620-71
    ADM
        ADM                  132459770001 342568759  JAKAITIS         JANIE      01   21298412495          12/28/2022           1      $323.00     $179.96
    ADM Total                                                                                                                          $323.00     $179.96
    COBRA
      COBRA                  132459781001 353583992  BUTTA            DEBRA      18   21498981805          01/03/2023           1      $105.00       $1.00
      COBRA                  132459781001 353583992  BUTTA            DEBRA      18   21498981805          01/03/2023           2      $250.00       $1.00
      COBRA                  132459781001 353583992  BUTTA            DEBRA      18   21498981805          01/03/2023           1      $115.00       $1.00
      COBRA                  132459781001 353583992  BUTTA            DEBRA      18   21498978318          12/19/2022           1      $230.00     $144.77
      COBRA                  132459781001 353583992  BUTTA            DEBRA      18   21498981805          01/03/2023           1      $120.00       $1.00
      COBRA                  130539785001 357560791  STARCEVICH       COREY      01   21565417229          07/30/2021           1      $270.00      $99.05
      COBRA                  127520137001 423965774  HAGOOD           JERRY      18   21198786208          12/30/2022           1       $58.00      $26.89

                                                                                                                                              PAGE:67 of 67
                                                                                                                                                            
            Group                UMI      Agreement        Patient Name         Rel          Claim          Incurred     #Days/    Submitted      Paid    
                                            Number   Last                First  Code           ID             Date       #Units     Charges      Claims   
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      COBRA                  127520137001 423965774  HAGOOD           JERRY      18   21198786208          12/30/2022           1      $500.00      $91.09
      COBRA                  127520137001 423965774  HAGOOD           JERRY      18   21198784199          12/30/2022           1       $41.00      $14.55
    COBRA Total                                                                                                                      $1,689.00     $380.35
    HCSLS
      HCSLS                  127519435001 189507083  BURDA            EDWARD     18   21198810801          11/17/2022           1      $700.00      $87.61
    HCSLS Total                                                                                                                        $700.00      $87.61
  025620-71 Total                                                                                                                    $2,712.00     $647.92
PPO Total                                                                                                                          $553,010.05 $211,626.00
Paid Claims Detail Total                                                                                                                       $299,120.62